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January 20, 2023Journal of Interventional Cardiac ElectrophysiologyOpen Access

Improved 1-year outcomes after active cooling during left atrial radiofrequency ablation

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Why the study?

Active esophageal cooling during RF ablation for AF is increasingly used to reduce injury, with randomized data showing trends toward increased freedom from AF, but comparisons of 1-year arrhythmia recurrence against LET monitoring were needed.

Does active esophageal cooling improve freedom from atrial fibrillation in patients undergoing left atrial radiofrequency ablation compared to traditional luminal esophageal temperature monitoring?

Comparison

Active esophageal cooling vs traditional LET monitoring

Design

Multicenter retrospective cohort study

Follow-up

1 year

Authors

CJChristopher JosephJNJose NazariJZJason Zagrodzky

Discussion

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Member takes

Overview

Active cooling was associated with higher 1-year AF freedom; leaves open confirmation in randomized trials before changing practice.

Structured PICO

Does active esophageal cooling improve freedom from atrial fibrillation in patients undergoing left atrial radiofrequency ablation compared to traditional luminal esophageal temperature monitoring?

P
Population
513 patients receiving pulmonary vein isolation (PVI) with radiofrequency (RF) ablation for the treatment of atrial fibrillation (AF). Mean age 66.8, 36.8% female. 60.1% paroxysmal AF, 34.3% persistent AF, and 5.6% long-standing persistent AF.
I
Intervention
Active esophageal cooling during left atrial radiofrequency ablation
C
Comparator
Traditional luminal esophageal temperature (LET) monitoring using either single or multi-sensor temperature probes
O
Outcome
Freedom from atrial fibrillation (AF) at 1-year follow-uphard clinical

Active esophageal cooling during left atrial radiofrequency ablation for atrial fibrillation is associated with a significantly higher rate of freedom from arrhythmia at 1 year compared to traditional temperature monitoring.

Limitations

  • Retrospective, non-randomized design requiring prospective or randomized validation

Cite This Study

Joseph et al. (2023) studied this question.

synapsesocial.com/papers/6a8ab0195246293882fda273https://doi.org/10.1007/s10840-023-01474-3
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