Real-time monitoring of luminal esophageal temperature during left atrial radiofrequency catheter ablation for atrial fibrillation: observations about esophageal heating during ablation at the pulmonary vein ostia and posterior left atrium.

Published

Journal Article

INTRODUCTION: Left atrial radiofrequency catheter ablation (RFA) is gaining acceptance as treatment for drug-refractory atrial fibrillation (AF). This therapy has been associated with esophageal injury and atrioesophageal fistula formation causing death. METHODS: We describe 3 patients undergoing catheter ablation for AF during real-time monitoring of luminal esophageal temperature. RESULTS: We observed heating of the esophagus during short duration low power RFA, at either the left or right pulmonary vein ostia. Cryoablation at the pulmonary vein ostium in one patient resulted in esophageal cooling. Furthermore, we observed that fluoroscopic localization of the ablation catheter at a site apparently distant from the esophagus is not adequate to assure avoidance of ablation-induced esophageal heating. CONCLUSIONS: Real-time monitoring of luminal esophageal position and temperature is feasible, enhances recognition of esophageal heating, and may add useful information beyond that provided by fluoroscopic assessment of esophageal position. There is a potential role for esophageal monitoring to help avoid thermal injury to the esophagus during catheter ablation for atrial fibrillation.

Full Text

Duke Authors

Cited Authors

  • Perzanowski, C; Teplitsky, L; Hranitzky, PM; Bahnson, TD

Published Date

  • February 2006

Published In

Volume / Issue

  • 17 / 2

Start / End Page

  • 166 - 170

PubMed ID

  • 16533254

Pubmed Central ID

  • 16533254

Electronic International Standard Serial Number (EISSN)

  • 1540-8167

International Standard Serial Number (ISSN)

  • 1045-3873

Digital Object Identifier (DOI)

  • 10.1111/j.1540-8167.2005.00333.x

Language

  • eng