Procedural time reduction associated with active esophageal cooling during pulmonary vein isolation.

Area of Science:

• Cardiology
• Electrophysiology
• Medical Device Technology

Background:

• Active esophageal cooling is an alternative to luminal esophageal temperature (LET) monitoring for preventing thermal injury during pulmonary vein isolation (PVI) for atrial fibrillation (AF).
• While active cooling's efficacy in reducing thermal injury is established, its impact on procedural efficiency requires further characterization.
• LET monitoring can cause procedure delays due to heat stacking and overheating alarms, unlike active esophageal cooling.

Purpose of the Study:

• To quantify the change in PVI procedure duration after implementing active esophageal cooling.
• To compare procedural efficiency between active esophageal cooling and LET monitoring.

Main Methods:

• Retrospective review of patients undergoing PVI between January 2018 and February 2020.
• Comparison of total procedure times between patients who underwent LET monitoring and those who used active esophageal cooling.
• Analysis included patient demographics (age, gender) and procedure duration.

Main Results:

• Mean procedure time was significantly reduced by 36 minutes (24.7%) with active esophageal cooling (110 min) compared to LET monitoring (146 min) (p < .001).
• Median procedure time decreased by 41 minutes (29.1%) with active cooling (100 min) versus LET monitoring (141 min) (p < .001).
• No significant differences in patient characteristics were observed between the groups.

Conclusions:

• Active esophageal cooling is associated with a substantial reduction in procedure duration during PVI.
• This finding suggests improved procedural efficiency when using active esophageal cooling over LET monitoring for esophageal protection.