Atrial Fibrillation Ablation with Esophageal Cooling with a Cooled Water-Irrigated Intraesophageal Balloon: A Pilot Study

Introduction: A left atrioesophageal fistula is an uncommon but devastating complication that may occur during atrial fibrillation (AF) ablation, and may be due to thermal injury occurring during the radiofrequency (RF) ablation. We examined the feasibility of an esophageal cooling (ECO) method usin...

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Bibliographic Details
Published in:Journal of cardiovascular electrophysiology 2007-02, Vol.18 (2), p.145-150
Main Authors: TSUCHIYA, TAKESHI, ASHIKAGA, KEIICHI, NAKAGAWA, SUSUMU, HAYASHIDA, KIYOSHI, KUGIMIYA, HIROSHI
Format: Article
Language:English
Subjects:
atrial fibrillation
Atrial Fibrillation - therapy
Body Temperature
Catheter Ablation - instrumentation
Catheter Ablation - methods
Catheterization - instrumentation
Catheterization - methods
Equipment Design
esophageal cooling
Esophagus - physiology
Female
Humans
Male
Middle Aged
Monitoring, Physiologic - methods
Pilot Projects
radiofrequency catheter ablation
Therapeutic Irrigation - methods
Treatment Outcome
Water
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Summary:Introduction: A left atrioesophageal fistula is an uncommon but devastating complication that may occur during atrial fibrillation (AF) ablation, and may be due to thermal injury occurring during the radiofrequency (RF) ablation. We examined the feasibility of an esophageal cooling (ECO) method using a cooled water‐irrigated intraesophageal balloon (IB). Methods and Results: Eight patients with drug‐refractory AF underwent RF catheter ablation to encircle the ipsilateral pulmonary veins. During the RF ablation at the posterior left atrium, the esophageal lumen was cooled using a 9‐Fr. IB catheter with a balloon length of 40 mm and diameter of 10 mm, in which cooled water, with a water temperature of 4.5 ± 3.1 °C, was irrigated while the luminal esophageal temperature (LET) was measured with an intraesophageal probe placed at a site close to the tip of the ablation catheter. In the control, the LET increased from 36.4 ± 0.8 °C to 40.5 ± 1.7 °C within 26.1 ± 8.2 seconds during 3.9 ± 1.2 RF energy applications, whereas with the ECO the LET decreased to 30.2 ± 2.9 °C at baseline (P
ISSN:1045-3873
1540-8167
DOI:10.1111/j.1540-8167.2006.00693.x