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Fasano A, Anfuso L, Arena G, et al. Thermal Field in Cryoablation Procedures for Pulmonary Veins Isolation: Importance of Esophageal Temperature Monitoring. J Atr Fibrillation. 2017;9(6):1533doi: 10.4022/jafib.1533.
Fasano, A., Anfuso, L., Arena, G., & Pandozi, C. (2017). Thermal Field in Cryoablation Procedures for Pulmonary Veins Isolation: Importance of Esophageal Temperature Monitoring. Journal of atrial fibrillation, 9(6), 1533. https://doi.org/10.4022/jafib.1533
Fasano, Antonio, et al. "Thermal Field in Cryoablation Procedures for Pulmonary Veins Isolation: Importance of Esophageal Temperature Monitoring." Journal of atrial fibrillation vol. 9,6 (2017): 1533. doi: https://doi.org/10.4022/jafib.1533
Fasano A, Anfuso L, Arena G, Pandozi C. Thermal Field in Cryoablation Procedures for Pulmonary Veins Isolation: Importance of Esophageal Temperature Monitoring. J Atr Fibrillation. 2017 Apr 30;9(6):1533. doi: 10.4022/jafib.1533. eCollection 2017. PMID: 29250288; PMCID: PMC5673338.
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J Atr Fibrillation. 2017 Apr 30;9(6):1533. doi: 10.4022/jafib.1533. eCollection 2017.

Thermal Field in Cryoablation Procedures for Pulmonary Veins Isolation: Importance of Esophageal Temperature Monitoring.

Journal of atrial fibrillation

Antonio Fasano, Luca Anfuso, Giuseppe Arena, Claudio Pandozi

Affiliations

  1. Dept. of Mathematics and Informatics U. Dini, Univ. of Florence, Italy, Associated to IASI_CNR, Rome, Italy.
  2. FIAB, Florence, Italy.
  3. Coronary Unit, Apuane Hospital, Massa, Italy.
  4. Cardiovascular Department, San Filippo Neri Hospital, Rome, Italy.

PMID: 29250288 PMCID: PMC5673338 DOI: 10.4022/jafib.1533

Abstract

BACKGROUND: Cryoablation procedures for pulmonary veins isolation have proved to be a successful treatment of atrial fibrillation, but exposure of surrounding organs to excessively low temperatures is potentially dangerous. Hence the importance of monitoring esophageal temperature and at the same time predicting the thermal field induced by the procedure, so to provide clinicians with a valuable tool to take critical decisions.

METHODS AND RESULTS: We formulate a mathematical model for computing the temperature in the relevant region and we use numerical simulations to interpret recorded clinical data. The temperature at the outer esophageal surface can be much lower than the luminal one. Observing the esophageal lumen cooling rate at the early stage of the procedure it is possible to forecast whether temperature is bound to reach dangerous values; the same quantity has a correlation with the steepness of the transesophageal thermal gradient.

CONCLUSION: Monitoring the time evolution of luminal esophageal temperature is of fundamental importance not only to realize but also to predict well in advance critical developments of the procedure.

Keywords: atrial fibrillation; cryo-ablation; esophageal lesion; esophageal temperature monitoring; pulmonary veins isolation; thermal field computation

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