title: Difference in thermodynamics between two types of esophageal temperature probes: Insights from an experimental study.
abstract: Luminal esophageal temperature monitoring is performed with a variety of temperature probes, but little is known about the relationship between the structure of a given probe and its thermodynamic characteristics.
  
  
  
  The purpose of this study was to evaluate the difference in thermodynamics between a 9Fr standard esophageal probe and an 18Fr esophageal stethoscope.
  
  
  
  In the experimental setting, each probe was submerged in a constant temperature water bath maintained at 42°C; in the patient setting, we monitored the temperature with both probes at the same time.
  
  
  
  The time constant of the stethoscope was higher than that of the probe (33.5 vs 8.3 s). Compared to the probe, the mean temperature measured by the stethoscope at 10 seconds was significantly lower (22.5°C ± 0.4°C vs 33.5°C ± 0.3°C, P<.0001), whereas the time to reach the peak temperature was significantly longer (132.6 ± 5.9 s vs 38.8 ± 1.0 s, P<.0001). Even in the ablation cases we observed that when the esophageal probe reached a peak temperature of 39.6°C ± 0.3°C, the esophageal stethoscope still displayed a temperature of 37.3°C ± 0.2°C (a mean of 2.39°C ± 0.3°C lower, P<.0001), showing a <0.5°C increase in temperature half of the times.
  
  
  
  The 18Fr esophageal stethoscope has a significantly slower time response compared to the 9Fr esophageal probe. In the clinical setting, this might result in a considerable underestimation of the luminal esophageal temperature with potentially fatal consequences.
authors.affiliation: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Carola
authors.initials: C
authors.lastname: Gianni
authors.affiliation: Division of Cardiovascular Diseases, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Moustapha
authors.initials: M
authors.lastname: Atoui
authors.affiliation: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas; Dell Medical School, University of Texas, Austin, Texas.
authors.forename: Sanghamitra
authors.initials: S
authors.lastname: Mohanty
authors.affiliation: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas.
authors.forename: Chintan
authors.initials: C
authors.lastname: Trivedi
authors.affiliation: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas.
authors.forename: Rong
authors.initials: R
authors.lastname: Bai
authors.affiliation: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas.
authors.forename: Amin
authors.initials: A
authors.lastname: Al-Ahmad
authors.affiliation: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas.
authors.forename: J David
authors.initials: JD
authors.lastname: Burkhardt
authors.affiliation: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas.
authors.forename: G Joseph
authors.initials: GJ
authors.lastname: Gallinghouse
authors.affiliation: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Hranitzky
authors.affiliation: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas; Department of Biomedical Engineering, University of Texas, Austin, Texas.
authors.forename: Rodney P
authors.initials: RP
authors.lastname: Horton
authors.affiliation: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas.
authors.forename: Javier E
authors.initials: JE
authors.lastname: Sanchez
authors.affiliation: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas; Department of Biomedical Engineering, University of Texas, Austin, Texas; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York; Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Biase
authors.affiliation: Division of Cardiovascular Diseases, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Dhanunjaya R
authors.initials: DR
authors.lastname: Lakkireddy
authors.affiliation: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas; Dell Medical School, University of Texas, Austin, Texas; Department of Biomedical Engineering, University of Texas, Austin, Texas; Interventional Electrophysiology, Scripps Clinic, La Jolla, California; MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio; Division of Cardiology, Stanford University, Stanford, California; Electrophysiology and Arrhythmia Services, California Pacific Medical Center, San Francisco, California. Electronic address: dr.natale@gmail.com.
authors.forename: Andrea
authors.initials: A
authors.lastname: Natale
mesh_terms: D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D004937:Esophageal Fistula / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D004947:Esophagus / Q000293:injuries / Q000473:pathology; D005471:Fluoroscopy / Q000379:methods; D006325:Heart Atria / Q000293:injuries / Q000473:pathology; D006358:Hot Temperature / Q000009:adverse effects*; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D016343:Monitoring, Intraoperative / Q000379:methods; D017063:Outcome Assessment, Health Care; D012107:Research Design; D019023:Stethoscopes; D013816:Thermodynamics; D013997:Time Factors
keywords: Atrio-esophageal fistula; Esophageal luminal temperature monitoring; Esophagus; Temperature probe; Thermodynamics