Why the study?
Can monitoring the time evolution of luminal esophageal temperature predict dangerous thermal fields during cryoablation for pulmonary vein isolation?
Can monitoring the time evolution of luminal esophageal temperature predict dangerous thermal fields during cryoablation for pulmonary vein isolation?
Monitoring the early cooling rate of the esophageal lumen during cryoablation can predict dangerous temperature drops at the outer esophageal surface, potentially preventing thermal injury.
Thermal modeling may aid esophageal monitoring during AF cryoablation; leaves open prospective validation before clinical use.
BACKGROUND: Cryoablation procedures for pulmonary veins isolation have proved to be a successful treatment of atrial fibrillation, but exposure of surrounding organs to excessively low temperatures is potentially dangerous. Hence the importance of monitoring esophageal temperature and at the same time predicting the thermal field induced by the procedure, so to provide clinicians with a valuable tool to take critical decisions. METHODS AND RESULTS: We formulate a mathematical model for computing the temperature in the relevant region and we use numerical simulations to interpret recorded clinical data. The temperature at the outer esophageal surface can be much lower than the luminal one. Observing the esophageal lumen cooling rate at the early stage of the procedure it is possible to forecast whether temperature is bound to reach dangerous values; the same quantity has a correlation with the steepness of the transesophageal thermal gradient. CONCLUSION: Monitoring the time evolution of luminal esophageal temperature is of fundamental importance not only to realize but also to predict well in advance critical developments of the procedure.
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Fasano et al. (2017) studied this question.
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