Cooling or warming the esophagus to reduce esophageal injury during left atrial ablation in the treatment of atrial fibrillation

Jason Zagrodzky, Mark M. Gallagher, Lisa W.M. Leung, Tiffany Sharkoski, Pasquale Santangeli, Cory Tschabrunn, Jose M. Guerra, Bieito Campos, John Macgregor, Jamal Hayat, Brad Clark, Alex Mazur, Marcel Feher, Martin Arnold, Mark Metzl, Jose Nazari, Erik Kulstad

Research output: Contribution to journalArticlepeer-review

Abstract

Ablation of the left atrium using either radiofrequency (RF) or cryothermal energy is an effective treatment for atrial fibrillation (AF) and is the most frequent type of cardiac ablation procedure performed. Although generally safe, collateral injury to surrounding structures, particularly the esophagus, remains a concern. Cooling or warming the esophagus to counteract the heat from RF ablation, or the cold from cryoablation, is a method that is used to reduce thermal esophageal injury, and there are increasing data to support this approach. This protocol describes the use of a commercially available esophageal temperature management device to cool or warm the esophagus to reduce esophageal injury during left atrial ablation. The temperature management device is powered by standard water-blanket heat exchangers, and is shaped like a standard orogastric tube placed for gastric suctioning and decompression. Water circulates through the device in a closed-loop circuit, transferring heat across the silicone walls of the device, through the esophageal wall. Placement of the device is analogous to the placement of a typical orogastric tube, and temperature is adjusted via the external heat-exchanger console.

Original languageEnglish (US)
Article numbere60733
JournalJournal of Visualized Experiments
Volume2020
Issue number157
DOIs
StatePublished - Mar 2020
Externally publishedYes

Keywords

  • Atrial fibrillation
  • Atrioesophageal fistula
  • Cryoablation
  • Esophageal cooling
  • Esophageal injury
  • Esophageal warming
  • Issue 157
  • Medicine
  • Radiofrequency ablation

ASJC Scopus subject areas

  • Neuroscience(all)
  • Chemical Engineering(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)

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