title: Esophageal luminal temperature measurement underestimates esophageal tissue temperature during radiofrequency ablation within the canine left atrium: comparison between 8 mm tip and open irrigation catheters.
abstract: BACKGROUND
  Evaluation of luminal temperature during left atrial ablation is used clinically; however, luminal temperature does not necessarily reflect temperature within the esophageal wall and poses a risk of atrioesophageal fistula. This animal study evaluates luminal esophageal temperature and its relation to the temperature of the external esophageal tissue during left atrial lesions using the 8 mm solid tip and the open irrigated tip catheters (OIC).
  
  
  RESULTS
  A thermocouple was secured to the external surface of the esophagus at the level of the left atrium of the dogs. Luminal esophageal temperature was measured using a standard temperature probe. In four randomized dogs, lesions were placed using an 8 mm solid tip ablation catheter. In six randomized dogs, lesions were placed using the 3.5 mm OIC. The average peak esophageal tissue temperature when using the OIC was significantly higher than that of the 8 mm tip catheter (88.6 degrees C +/- 15.0 degrees C vs. 62.3 degrees C +/- 12.5 degrees C, P < 0.05). Both OIC and 8 mm tip catheter had significantly higher peak tissue temperatures than luminal temperatures (OIC: 88.6 degrees C +/- 15.0 degrees C vs 39.7 degrees C +/- 0.82 degrees C, P < 0.05) (8 mm: 62.3 degrees C +/- 12.5 degrees C vs 39.0 +/- 0.5 degrees C, P < 0.05). Both catheters achieved peak temperatures faster in the tissue as compared to the lumen of the esophagus, although the tissue temperature peaked significantly faster for the OIC (OIC: 25 seconds vs 90 seconds, P < 0.05) (8 mm: 63 seconds vs 105 seconds, P < 0.05).
  
  
  CONCLUSIONS
  Despite the significant difference in actual tissue temperatures, no significant difference was observed in luminal temperatures between the OIC and 8 mm tip catheter.
authors: Department of Cardiovascular Medicine, Section of Electrophysiology and Pacing, Cleveland Clinic, Cleveland, Ohio, USA. cumminj@ccf.org
authors: Jennifer E
authors: JE
authors: Cummings
authors: Conor D
authors: CD
authors: Barrett
authors: Kenneth N
authors: KN
authors: Litwak
authors: Luigi
authors: L
authors: DI Biase
authors: Punam
authors: P
authors: Chowdhury
authors: Seil
authors: S
authors: Oh
authors: Chi Keong
authors: CK
authors: Ching
authors: Walid I
authors: WI
authors: Saliba
authors: Robert A
authors: RA
authors: Schweikert
authors: J David
authors: JD
authors: Burkhardt
authors: Shari
authors: S
authors: DE Marco
authors: Luciana
authors: L
authors: Armaganijan
authors: Andrea
authors: A
authors: Natale
mesh_terms: D000818:Animals; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D001831:Body Temperature / Q000502:physiology*; D017115:Catheter Ablation / Q000379:methods*; D004195:Disease Models, Animal; D004285:Dogs; D004947:Esophagus / Q000503:physiopathology*; D005500:Follow-Up Studies; D016343:Monitoring, Intraoperative / Q000379:methods*; D015203:Reproducibility of Results; D007507:Therapeutic Irrigation / Q000295:instrumentation*; D013821:Thermometers