title: Multi-sensor esophageal temperature probe used during radiofrequency ablation for atrial fibrillation is associated with increased intraluminal temperature detection and increased risk of esophageal injury compared to single-sensor probe.
abstract: BACKGROUND
  Radiofrequency (RF) ablation in the posterior left atrium has risk of thermal injury to the adjacent esophagus. Increased intraluminal esophageal temperature has been correlated with risk of esophageal injury. The objective of this study was to compare esophageal temperature monitoring (ETM) using a multi-sensor temperature probe with 12 sensors to a single-sensor probe during catheter ablation for atrial fibrillation (AF).
  
  
  RESULTS
  We compared the detection of intraluminal esophageal temperature rises in 543 patients undergoing RF ablation for AF with ETM. Esophageal endoscopy (EGD) was performed on all patients with maximum esophageal temperature ≥ 39°C. Esophageal lesions were classified by severity as mild or severe ulcerations. Four hundred fifty-five patients underwent RF ablation with single-sensor ETM and 88 patients with multi-sensor ETM. Thirty-nine percent of patients with single-sensor versus 75% with multi-sensor ETM reached a maximum detected esophageal temperature ≥ 39°C (P < 0.0001). Esophageal injury was detected by EGD in 29% of patients with maximum temperature ≥ 39°C by single-sensor versus 46% of patients with multi-sensor ETM (P = 0.021). Thirty-nine percent of patients with lesions in the single-sensor probe group had severe ulcerations compared to 33% of patients in the multi-sensor probe group (P = 0.641).
  
  
  CONCLUSIONS
  Intraluminal esophageal temperature ≥ 39°C is detected more frequently by the multi-sensor temperature probe versus the single-sensor probe, with more frequent esophageal injury and with comparable severity of injury. Despite detecting esophageal temperature rises in more patients, the multi-sensor probe may not have any measurable benefit compared to a single-sensor probe.
authors.affiliation: Department of Medicine.
authors.forename: Brett J
authors.initials: BJ
authors.lastname: Carroll
authors.forename: Fernando M
authors.initials: FM
authors.lastname: Contreras-Valdes
authors.forename: E Kevin
authors.initials: EK
authors.lastname: Heist
authors.forename: Conor D
authors.initials: CD
authors.lastname: Barrett
authors.forename: Stephan B
authors.initials: SB
authors.lastname: Danik
authors.forename: Jeremy N
authors.initials: JN
authors.lastname: Ruskin
authors.forename: Moussa
authors.initials: M
authors.lastname: Mansour
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery*; D001831:Body Temperature / Q000502:physiology*; D017115:Catheter Ablation / Q000009:adverse effects* / Q000295:instrumentation; D004947:Esophagus / Q000293:injuries* / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D064795:Intraoperative Neurophysiological Monitoring / Q000009:adverse effects* / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: atrial fibrillation; catheter ablation; complications; electrophysiology; esophageal injury; esophageal temperature monitoring; pulmonary vein isolation