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Association Between Proactive Esophageal Cooling and Increased Lab Throughput
  • +14
  • William Zagrodzky,
  • Julie Cooper,
  • Christopher Joseph,
  • Matthew Sackett,
  • Jose Silva,
  • Richard Kuk,
  • Julia McHugh,
  • Babette Brumback,
  • Shirley Park,
  • Robert Hayward,
  • Taresh Taneja,
  • Andrew Vu,
  • Taylor Liu,
  • Erik Kulstad,
  • Andrew Kaplan,
  • Archana Ramireddy,
  • Samuel Omotoye
William Zagrodzky
Colorado College

Corresponding Author:william.zagrodzky1@gmail.com

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Julie Cooper
The University of Texas Southwestern Medical Center
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Christopher Joseph
The University of Texas Southwestern Medical Center
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Matthew Sackett
Centra Health
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Jose Silva
Centra Health
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Richard Kuk
Centra Health
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Julia McHugh
Centra Health
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Babette Brumback
University of Florida Department of Biostatistics
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Shirley Park
Kaiser Permanente Santa Clara Medical Center
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Robert Hayward
Kaiser Permanente Santa Clara Medical Center
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Taresh Taneja
Kaiser Permanente Santa Clara Medical Center
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Andrew Vu
Kaiser Permanente Santa Clara Medical Center
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Taylor Liu
Kaiser Permanente Santa Clara Medical Center
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Erik Kulstad
The University of Texas Southwestern Medical Center
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Andrew Kaplan
Banner Heart Hospital
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Archana Ramireddy
Cedars-Sinai Medical Center Palliative Care Services
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Samuel Omotoye
Cleveland Clinic
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Abstract

Introduction: Proactive esophageal cooling has been FDA cleared to reduce the likelihood of ablation-related esophageal injury resulting from radiofrequency (RF) cardiac ablation procedures. Data suggest that procedure times for RF pulmonary vein isolation (PVI) also decrease when proactive esophageal cooling is employed instead of luminal esophageal temperature (LET) monitoring. Reduced procedure times may allow increased electrophysiology (EP) lab throughput. We aimed to quantify the change in EP lab throughput of PVI cases after the introduction of proactive esophageal cooling. Methods: EP lab throughput data were obtained from three electrophysiology groups. We then compared EP lab throughput over equal time frames at each site before (pre-adoption) and after (post-adoption) the adoption of proactive esophageal cooling. Results: Over the time frame of the study, a total of 2,498 PVIs were performed over a combined 74 months, with cooling adopted in September 2021, November 2021 and March 2022 at each respective site. In the pre-adoption time frame, 1,026 PVIs were performed using a combination of LET monitoring with the addition of esophageal deviation when deemed necessary by the operator. In the post-adoption time frame, 1,472 PVIs were performed using exclusively proactive esophageal cooling, representing a mean 43% increase in throughput (p < 0.0001), despite the loss of two operators during the post-adoption time frame. Conclusion: Adoption of proactive esophageal cooling during PVI ablation procedures is associated with a significant increase in EP lab throughput, even after a reduction in total number of operating physicians in the post-adoption group.
26 Jan 2024Submitted to Journal of Cardiovascular Electrophysiology
26 Jan 2024Submission Checks Completed
26 Jan 2024Assigned to Editor
26 Jan 2024Review(s) Completed, Editorial Evaluation Pending
27 Jan 2024Reviewer(s) Assigned
29 Feb 20241st Revision Received
02 Mar 2024Submission Checks Completed
02 Mar 2024Assigned to Editor
02 Mar 2024Review(s) Completed, Editorial Evaluation Pending
02 Mar 2024Reviewer(s) Assigned
16 Mar 2024Editorial Decision: Accept
03 Apr 2024Published in Journal of Cardiovascular Electrophysiology. doi.org/10.1111/jce.16263