REVIEW

Journal of Interventional Cardiac Electrophysiology

, Volume 35, Issue 1, pp 35-44

Prevention of esophageal thermal injury during radiofrequency ablation for atrial fibrillation

  • Enzhao LiuAffiliated withThe Heart Institute, Cedars Sinai Medical Center
  • , Michael ShehataAffiliated withThe Heart Institute, Cedars Sinai Medical Center
  • , Tong LiuAffiliated withThe Heart Institute, Cedars Sinai Medical Center
  • , Allen AmornAffiliated withThe Heart Institute, Cedars Sinai Medical Center
  • , Eugenio CingolaniAffiliated withThe Heart Institute, Cedars Sinai Medical Center
  • , Vinod KannarkatAffiliated withThe Heart Institute, Cedars Sinai Medical Center
  • , Sumeet S. ChughAffiliated withThe Heart Institute, Cedars Sinai Medical Center
  • , Xunzhang WangAffiliated withThe Heart Institute, Cedars Sinai Medical CenterHeart Rhythm Center, The Heart Institute, Cedars–Sinai Health System Email author 

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

Pulmonary vein isolation using radiofrequency ablation is an effective therapy in patients with atrial fibrillation. However, the esophagus descends in close proximity to the posterior wall of the left atrium and renders this structure susceptible to thermal injury. Esophageal ulceration has been hypothesized to be a precursor to left atrial–esophageal fistula, a procedural complication associated with poor prognosis. In this review, we have analyzed and summarized the published data regarding esophageal thermal injury during catheter ablation for atrial fibrillation and strategies to minimize risk of this complication. While esophageal temperature monitoring can be useful, multiple factors such as patient characteristics and specific strategies for radiofrequency energy delivery also merit consideration.

Keywords

Atrial fibrillation Radiofrequency ablation Left atrium Esophageal ulceration Esophageal temperature monitoring