title: Comparison between single- and multi-sensor oesophageal temperature probes during atrial fibrillation ablation: thermodynamic characteristics.
abstract: OBJECTIVE
  Oesophageal temperature monitoring with single-sensor probe (SSP) has a variable ability to predict oesophageal ulceration as a consequence of pulmonary vein isolation (PVI). Multi-sensor self-expandable probes (MSPs) may offer improved thermal monitoring. The objective of this study was to compare the thermodynamic characteristics of both probes during PVI.
  
  
  RESULTS
  This prospective study enrolled 20 patients undergoing index PVI. Ten patients (group A) underwent dual monitoring with SSP and MSP and 10 control patients (group B) were monitored with SSP alone. Time to initial rise (>0.2°C), time to 1.0°C rise, peak temperature, and decay were recorded with each posterior wall lesion (20 W, 198 applications). The operator was blinded to the MSP temperature data and ablation was only interrupted when SSP temperature increased by ≥2°C. All patients underwent endoscopy within 24 h. Initial temperature increase was detected earlier with MSP (13.4 ± 7.5 vs. 30.5 ± 15.4 s; P < 0.001); led to shorter time to 1.0°C rise (18.5 ± 10.1 vs. 32.1 ± 12.0 s; P < 0.001); and higher change in peak temperature (1.6 ± 2.0 vs. 0.60 ± 0.53°C; P < 0.001). Decay time was similar between the probes (146.1 ± 35.3 vs. 150.4 ± 48.4 s; P = 0.89). The incidence of oesophageal ulceration was similar between the Groups A and B (5 and 4, respectively). Multi-sensor self-expandable probe provided greater sensitivity (100 vs. 60%) and similar specificity (60%) for detection of oesophageal ulceration. Five swine underwent oesophageal mapping before and after MSP placement without alteration in size or position.
  
  
  CONCLUSIONS
  Multi-sensor probes provide a superior thermodynamic profile. Its clinical value in reducing oesophageal injury requires further evaluation.
authors.affiliation: Harvard-Thorndike Electrophysiology Institute, Cardiovascular Division, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Baker 4, Boston, MA 02215, USA.
authors.forename: Cory M
authors.initials: CM
authors.lastname: Tschabrunn
authors.affiliation: Harvard-Thorndike Electrophysiology Institute, Cardiovascular Division, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Baker 4, Boston, MA 02215, USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Silverstein
authors.affiliation: Center for Advanced Endoscopy, Gastroenterology Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Tyler
authors.initials: T
authors.lastname: Berzin
authors.affiliation: Harvard-Thorndike Electrophysiology Institute, Cardiovascular Division, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Baker 4, Boston, MA 02215, USA.
authors.forename: Ethan
authors.initials: E
authors.lastname: Ellis
authors.affiliation: Harvard-Thorndike Electrophysiology Institute, Cardiovascular Division, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Baker 4, Boston, MA 02215, USA.
authors.forename: Alfred E
authors.initials: AE
authors.lastname: Buxton
authors.affiliation: Harvard-Thorndike Electrophysiology Institute, Cardiovascular Division, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Baker 4, Boston, MA 02215, USA.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Josephson
authors.affiliation: Harvard-Thorndike Electrophysiology Institute, Cardiovascular Division, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Baker 4, Boston, MA 02215, USA eanter@bidmc.harvard.edu.
authors.forename: Elad
authors.initials: E
authors.lastname: Anter
mesh_terms: D000368:Aged; D000818:Animals; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods; D016145:Endoscopy, Digestive System; D004947:Esophagus / Q000000981:diagnostic imaging / Q000293:injuries*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000295:instrumentation*; D011667:Pulmonary Veins / Q000601:surgery*; D011859:Radiography; D034421:Sus scrofa; D013552:Swine; D013821:Thermometers
keywords: Atrial fibrillation; Multi-sensor probe; Oesophageal injury; Oesophageal temperature monitoring; Pulmonary vein isolation; Single-sensor probe