• Patrick Müller, Johannes-Wolfgang Dietrich, Philipp Halbfass, Aly Abouarab, Franziska Fochler, Atilla Szöllösi, Karin Nentwich, Markus Roos, Joachim Krug, Anja Schade, Andreas Mügge, and Thomas Deneke.
• Heart Center Bad Neustadt, Clinic for Interventional Electrophysiology; University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany. Electronic address: Patrick.Mueller-3@ruhr-uni-bochum.de.
• Heart Rhythm. 2015 Jul 1; 12 (7): 1464-9.

BackgroundEndoscopically detected esophageal lesions (EDELs) have been identified in apparently asymptomatic patients after catheter ablation of atrial fibrillation (AF). The use of esophageal probes to monitor luminal esophageal temperature (LET) during catheter ablation to protect esophageal damage is currently controversial.ObjectiveThe purpose of this study was to investigate the impact of the use of esophageal temperature probes during AF catheter ablation on the incidence of EDELs.MethodsEighty consecutive patients (mean age 63.8 ± 11.36 years; 68.8% men) with symptomatic, drug-refractory paroxysmal (n = 52, 65%) or persistent AF who underwent left atrial radiofrequency catheter ablation were prospectively enrolled. Posterior wall ablation was power limited (≤25 W). In the first 40 patients, LET was monitored continuously (group A), whereas no esophageal temperature probe was used in group B (n = 40 patients). Assessment of EDEL was performed by endoscopy within 2 days after radiofrequency catheter ablation.ResultsOverall, 13 patients (16%) developed EDELs after AF ablation. The incidence of EDELs was significantly higher in group A than group B (30% vs 2.5%, P < .01). Within group A, patients who developed EDEL had higher maximal LET during AF ablation than patients without EDEL (40.97 ± 0.92°C vs 40.14 ± 1.1°C, P = .02). Multivariable logistic regression analysis revealed the use of an esophageal temperature probe as the only independent predictor for the development of EDEL (odds ratio 16.7, P < .01).ConclusionThe use of esophageal temperature probes in the setting of AF catheter ablation per se appears to be a risk factor for the development of EDEL.Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

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