Mechanisms of Action Behind the Protective Effects of Proactive Esophageal Cooling During Radiofrequency Catheter Ablation in the Left Atrium
[EN] Proactive esophageal cooling for the purpose of reducing the likelihood ofablation-relatedesophagealinjury resulting from radiofrequency (RF) cardiac ablation procedures is increasingly being used and has been Food and Drug Administration cleared as a protective strategy during left atrial RF a...
| Autores: | , , , , , , , , , , , , , , |
|---|---|
| Tipo de recurso: | artículo |
| Fecha de publicación: | 2024 |
| País: | España |
| Institución: | Universitat Politècnica de València (UPV) |
| Repositorio: | RiuNet. Repositorio Institucional de la Universitat Politécnica de Valéncia |
| Idioma: | inglés |
| OAI Identifier: | oai:riunet.upv.es:10251/222644 |
| Acceso en línea: | https://riunet.upv.es/handle/10251/222644 |
| Access Level: | acceso abierto |
| Palabra clave: | Atrial fibrillation Radiofrequency ablation Pulmonary vein isolation Atrioesophageal fistula Esophageal cooling |
| Sumario: | [EN] Proactive esophageal cooling for the purpose of reducing the likelihood ofablation-relatedesophagealinjury resulting from radiofrequency (RF) cardiac ablation procedures is increasingly being used and has been Food and Drug Administration cleared as a protective strategy during left atrial RF ablation for the treatment of atrial fibrillation. In this review, we examine the evidence supporting the use of proactive esophageal cooling and the potential mechanisms of action that reduce the likelihood of atrioesophageal fistula (AEF) formation. Although the pathophysiology behindAEF formationafter thermalinjury fromRFablation is not well studied, a robust literature on fistula formation in other conditions (eg, Crohn disease, cancer, and trauma) exists and the relationship to AEF formation is investigated in this review. Likewise, we examine theabundant datain the surgicalliterature on burnand thermal injury progression as well as the acute and chronic mitigating effects of cooling.We discuss the relationship of these data andmaladaptive healingmechanisms to thewell-recognizedpostablation pathophysiological effects after RF ablation. Finally, we review additionalimportant considerations such as patient selection, clinical workflow, and implementation strategies for proactive esophageal cooling. |
|---|