Conclusion
Although the occurrence of AEF is low likelihood, the occurrence of
esophageal injury related to AF ablation is quite frequent (about 15%).
The concern for esophageal injury during AF ablation is a focus for
electrophysiologists and has resulted in numerous steps to try to
prevent injury: varied modalities used to identify the location/course
of esophagus, continuous monitoring of esophageal luminal temperature
with a variety of temperature monitoring systems, alteration of ablation
techniques and energy delivery, and empiric use of proton pump
inhibitors. Furthermore, the concern for AEF persists for a few weeks
post ablation, resulting in the costly and worrisome clinical scenario
of emergently excluding the presence of AEF in patients who present with
symptoms post ablation.
Certainly a reliable method to protect the esophagus is of clinical
value, but the ancillary value of reducing physician concern during AF
ablation, reducing interruption to ablation work flow, perhaps enhancing
AF ablation results34 and simplifying post procedure
management of patient symptoms are also of high importance. Considering
the ease of use, minimal side effects, and low costs associated with
esophageal protection devices, these features offer compelling evidence
for use of esophageal protection as routine care for AF ablation.
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