{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T14:02:26Z","timestamp":1775829746790,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,3,18]],"date-time":"2020-03-18T00:00:00Z","timestamp":1584489600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the prevalence of esophageal and periesophageal thermal injury in patients undergoing radiofrequency (RF) atrial fibrillation (AF) ablation using 8\u2009mm tip catheters during three different esophageal protection strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty\u2010five consecutive patients with paroxysmal or persistent AF underwent first ablation procedure, besides esophagogastroduodenoscopy (EGD) combined with radial endosonography (EUS) performed before and after the pulmonary vein (PV) isolation. Before the procedure, patients were randomly assigned to one of three esophageal lesion protection strategies: group I\u2014without any protective or monitoring dispositive and limiting RF applications to 30\u2009W for 20\u2009seconds, in left atrium posterior wall (LAPW); group II\u2014power and time of RF delivery, up to 50\u2009W for 20\u2009seconds at LAPW, limited by esophageal temperature monitoring; group III\u2014applications of RF in LAPW with fixed power application of 50\u2009W for 20\u2009seconds during continuous esophageal cooling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Baseline characteristics of patients were similar in all groups. The four PVs were isolated in 14 (93.3%), 13 (86.7%), and 15 (100%) patients, respectively in groups I, II, and III. The mean RF power was significantly higher (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) in the posterior side of PVs in group III. Post\u2010AF ablation EGD and EUS revealed two esophageal wall ulcerations and two periesophageal mediastinal edemas only in the esophageal cooling group (<jats:italic>P<\/jats:italic>\u2009=\u2009.008).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Esophageal cooling balloon strategy resulted in a higher RF power energy delivery when ablating at the LA posterior wall, using 8\u2009mm nonirrigated tip catheters under temperature mode control. Despite that, patients presented a relatively low incidence of esophageal and periesophaeal injuries.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.14417","type":"journal-article","created":{"date-parts":[[2020,2,28]],"date-time":"2020-02-28T12:23:13Z","timestamp":1582892593000},"page":"924-933","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Comparative study of strategies to prevent esophageal and periesophageal injury during atrial fibrillation ablation"],"prefix":"10.1111","volume":"31","author":[{"given":"Barbara D.","family":"de Oliveira","sequence":"first","affiliation":[{"name":"Cardiac Arrhythmia Service \u2010 Santa Casa Hospital  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena","family":"Oyama","sequence":"additional","affiliation":[{"name":"Bioengineering Service of Heart Institute University of S\u00e3o Paulo Medical School  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carina A.","family":"Hardy","sequence":"additional","affiliation":[{"name":"Cardiac Arrhythmias and Electrophysiology Unit, Heart Institute University of Sao Paulo Medical School  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sissy L.","family":"de Melo","sequence":"additional","affiliation":[{"name":"Cardiac Arrhythmias and Electrophysiology Unit, Heart Institute University of Sao Paulo Medical School  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristiano F.","family":"Pisani","sequence":"additional","affiliation":[{"name":"Cardiac Arrhythmias and Electrophysiology Unit, Heart Institute University of Sao Paulo Medical School  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6697-7074","authenticated-orcid":false,"given":"Muhieddine O.","family":"Chokr","sequence":"additional","affiliation":[{"name":"Cardiac Arrhythmias and Electrophysiology Unit, Heart Institute University of Sao Paulo Medical School  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0034-6549","authenticated-orcid":false,"given":"Conrado","family":"Balbo","sequence":"additional","affiliation":[{"name":"Cardiac Arrhythmias and Electrophysiology Unit, Heart Institute University of Sao Paulo Medical School  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco C.","family":"da Costa Darrieux","sequence":"additional","affiliation":[{"name":"Cardiac Arrhythmias and Electrophysiology Unit, Heart Institute University of Sao Paulo Medical School  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denise T.","family":"Hachul","sequence":"additional","affiliation":[{"name":"Cardiac Arrhythmias and Electrophysiology Unit, Heart Institute University of Sao Paulo Medical School  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dalton M.","family":"Chaves","sequence":"additional","affiliation":[{"name":"Endoscopy Service of Clinics' Hospital University of S\u00e3o Paulo Medical School  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. 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