The Lead Episode 26: A Discussion of Atrioesophageal Fistula Rates Before and After Adoption of Active Esophageal Cooling During Atrial Fibrillation Ablation-JACC: Clinical Electrophysiology 2023

JACC: Clinical Electrophysiology 2023

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A study conducted across multiple hospital systems has found that active esophageal cooling during radiofrequency catheter ablation of the left atrium for atrial fibrillation can significantly reduce the rate of atrioesophageal fistula (AEF) formation. The study included over 14,000 patients who underwent active esophageal cooling and found that the rate of AEF with active cooling was 0%, compared to 0.146% in patients who received luminal esophageal temperature monitoring before the adoption of cooling. The study suggests that active esophageal cooling can be an effective strategy for reducing the risk of AEF during ablation procedures for atrial fibrillation.<br /><br />Another study analyzed data from over 34,000 cases across 150 sites that had adopted active esophageal cooling and found that only one AEF occurred, representing a significant reduction in the expected rate of events using traditional methods of esophageal protection. Active esophageal cooling involves the use of a cooling device to protect the esophagus from thermal injury during ablation procedures. The study highlights the potential of this technology to improve patient safety during ablation procedures and reduce the risk of complications.<br /><br />While the study has some limitations, such as variations in data collection and including cases from different sites, the results provide important insights into the effectiveness of active esophageal cooling in reducing the risk of AEF. Further research is needed to confirm these findings and explore the long-term effects of active esophageal cooling on patient outcomes.<br /><br />In conclusion, the adoption of active esophageal cooling during radiofrequency ablation for atrial fibrillation can significantly reduce the rate of atrioesophageal fistula formation. This technology has the potential to improve patient safety and reduce the risk of complications during ablation procedures.

Keywords

study

hospital systems

active esophageal cooling

radiofrequency catheter ablation

atrial fibrillation

atrioesophageal fistula

AEF formation

luminal esophageal temperature monitoring

esophageal protection

patient safety