Cooling the Esophagus: Protecting Against Burns During Heart Procedures

When doctors use radiofrequency (RF) energy to treat atrial fibrillation in the left atrium, they face an unusual challenge: preventing burns in the nearby esophagus. New catheters can now deliver high wattages up to 90W for short bursts, a technique known as very high-power short duration (vHPSD) ablation. However, adjusting power and duration doesn't eliminate the risk. Even alternative energy sources like pulsed field ablation (PFA) can cause heat-related issues, with esophageal temperatures reaching up to 40. 3°C.To tackle this, the ensoETM esophageal cooling device (now part of Haemonetics) is available and cleared by the FDA. This device is designed to reduce thermal injury during these procedures. It's endorsed by experts in the field, appearing in the 2024 consensus statement on catheter and surgical ablation for atrial fibrillation. What makes this cooling device so important? It provides a shield for the esophagus, keeping it safe during these high-energy treatments. This is crucial because damaging the esophagus can lead to serious complications. Even with advanced tools, precautions matter. Medical advancements like these show how far we've come in protecting patients during delicate cardiac procedures, ensuring their comfort and safety.