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\begin{document}

\title{Evaluation of the efficacy and safety of the mechanical displacement in
the esophageal heating prevention during atrial fibrillation
radiofrequency ablation.}



\author[1]{RICARDO AMARANTE}%
\author[2]{José Carlos Mateos}%
\author[1]{Tasso  Lobo}%
\author[1]{Tomás Pena}%
\author[3]{Juan Zerpa}%
\author[1]{Carlos Pachón}%
\author[1]{Felipe Ortêncio}%
\author[4]{Thiago Guimarães Osório}%
\author[1]{Maria Zelia Pachon}%
\author[1]{Juan Pachon}%
\author[1]{Enrique Indalecio Pachon}%
\affil[1]{Hospital do Coração}%
\affil[2]{São Paulo Cardiology Institute Pacemaker Service}%
\affil[3]{Heart Hospital, Sao Paulo,}%
\affil[4]{Heart Rhythm Management Center, Cardiovascular Center UZ Brussel Vrij Universiteit Brussel, Dpt Cardiology laarbeeklaan 101 Brussel, Jette, BE 1090 0032-2-4763038, Cardiology Brussels, BE 0032-2-4763038}%


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  \date{June 08, 2024}


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\begin{abstract}
Introduction: As the pulmonary vein isolation (PVI) is the cornerstone
of the atrial fibrillation (AF) ablation procedure, esophagus
overheating has become a subject of great concern. Objectives: To assess
whether the mechanical displacement of the esophagus (MDE), performed by
a regular transesophageal echocardiogram probe (TEEP) may prevent
esophagus overheating during the procedure. Methods: A 55 patient
prospective-controlled study with paroxysmal or persistent AF in which
RF delivery was stopped, whenever a sinusoidal probe with multiple
thermocouples detected a luminal esophageal temperature (LET) elevation
[?]0.5\selectlanguage{ngerman}°C. A LET elevation \textless{}0.5°C during RF delivery was
considered the successful endpoint after performed the MDE. In some
patients, diluted barium was instilled to highlight the esophagus
boundaries. Esophagogastroduodenoscopy (EGD) was performed if there were
any sign or symptom of esophagus injury after the procedure. Results:
The MDE was necessary in 47 of the 55 subjects enrolled to correct LET
elevation (\selectlanguage{english}[?]0.5degC). After the MDE, 41 of those 47 patients had a LET
elevation \textless{}0.5degC, and none of them, had a LET elevation
\selectlanguage{english}[?]38.5degC. The average basal LET was 35.71 +- 0.12degC. Immediately before
the MDE, the average LET was 37.03 +- 0.06degC and post-displacement was
35.83 +- 0.08degC. The displacement range average was 2.25+- 1.19cm
(maximum: 6.17cm). After displacement, 100\% of the esophagus remained
in the same position. Of the total 14 patients who underwent EGD, 6 were
normal, erosion was detected in 1 and superficial hematoma in 7.
Conclusion: the MDE was effective and safe in preventing its overheating
during RF catheter AF ablation.%
\end{abstract}\selectlanguage{ngerman}%



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