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CA-528-01 PATTERNS OF ESOPHAGEAL TEMPERATURE CHANGE PREDICT ESOPHAGEAL THERMAL INJURY IN CATHETER ABLATION FOR ATRIAL FIBRILLATION

      Background

      Esophageal luminal temperature (ELT) monitoring during catheter ablation for atrial fibrillation (AF) is widely used to reduce the incidence of esophageal thermal injury (ETI).

      Objective

      We investigated whether specific patterns of temperature variation are associated with ETI.

      Methods

      We conducted an observational study on patients with paroxysmal or persistent AF undergoing radiofrequency (RF) or cryoballoon ablation (CBA) at the University of Washington between September 2019 and November 2021. The CIRCA-S multi-sensor probe (Circa Scientific) (panel A) was used to record high-fidelity ELT. Patients underwent upper endoscopy one day after ablation. ELT data were analyzed for patterns associated with ETI, including maximum and minimum temperature, number of peaks above 37°C (panel B), troughs below 30°C (panel C), number of spikes, area under the temperature curve (panel D).

      Results

      A total of 78 patients (61.5% paroxysmal AF; 30.8% female) were included. Among them, 61 patients underwent RF, and 17 patients CBA. ETI was detected in 10 patients (12.8%). Patients with ETI had a higher number of peaks or troughs recorded (3.3±1.7 vs. 2.25±1.11, p=0.041) and a lower area under the curve (632.9±681.27 vs. 1393.44±1761.97, p=0.038). Logistic regression analysis revealed that the total number of peaks/troughs was associated with an odds ratio [OR]: 1.78 for increased risk of ETI (confidence interval [CI]: 1.1 - 2.87; p=0.02), while the area under the curve’s OR was 1.65; ([CI]: 1.01 -2.72; p=0.048).