{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T08:52:47Z","timestamp":1789203167159,"version":"build-2803163510"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Pulmonary vein isolation is an established treatment option for atrial fibrillation. To date, the incidence and quality of ablation-induced esophageal thermal lesions (ETLs) using the recently introduced second-generation cryoballoon (CB, ArcticFront Advance, Medtronic) is unknown.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>In patients with drug-refractory paroxysmal atrial fibrillation or short-standing persistent atrial fibrillation, pulmonary vein (PV) isolation was performed using the second-generation CB. The endoluminal esophageal temperature was monitored via a temperature probe. After PV isolation, esophagogastroduodenoscopy (EGD) was performed to assess the incidence of ETLs. In 50 patients (18 women; age, 61\u00b111 years; left atrial diameter, 43\u00b15 mm), successful CB-based PV isolation was performed. Lowest median balloon temperature and esophageal temperature for the right superior PV were \u221251\u00b0C and 35.8\u00b0C, \u221247\u00b0C and 35\u00b0C for the right inferior PV, \u221251\u00b0C and 34.4\u00b0C for the left superior PV, \u221248\u00b0C and 34.6\u00b0C for the left inferior PV, and \u221254\u00b0C and 34.5\u00b0C for the left common PV, respectively. EGD performed 2\u00b11 days post ablation demonstrated superficial thermal lesions and thermal ulcerations in 1 of 50 (2%) and 5 of 50 (10%) patients, respectively. In patients with ETLs, during \u22651 freeze cycle the endoluminal esophageal temperature measured &lt;3.0\u00b0C. All thermal lesions were in the healing process on repeat EGD 4\u00b12 days after initial endoscopy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Using the second-generation 28-mm CB, ETLs were detected in 6 of 50 (12%) patients. All ETLs were in the healing process on repeat EGD. An esophageal temperature safety cutoff may prove valuable in the prevention of ETLs and requires further evaluation.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.113.000228","type":"journal-article","created":{"date-parts":[[2013,6,8]],"date-time":"2013-06-08T03:14:14Z","timestamp":1370661254000},"page":"769-775","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":130,"title":["Increased Incidence of Esophageal Thermal Lesions Using the Second-Generation 28-mm Cryoballoon"],"prefix":"10.1161","volume":"6","author":[{"given":"Andreas","family":"Metzner","sequence":"first","affiliation":[{"name":"From the Departments of Cardiology (A.M., P.W., P.R., A.B., C.G., R.R.T., A.R., S.M., S.D., H.M., F.O., K.-H.K., E.W.) and Internal Medicine (A.B.), Asklepios Klinik St. Georg, Hamburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre","family":"Burchard","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiology (A.M., P.W., P.R., A.B., C.G., R.R.T., A.R., S.M., S.D., H.M., F.O., K.-H.K., E.W.) and Internal Medicine (A.B.), Asklepios Klinik St. Georg, Hamburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Wohlmuth","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiology (A.M., P.W., P.R., A.B., C.G., R.R.T., A.R., S.M., S.D., H.M., F.O., K.-H.K., E.W.) and Internal Medicine (A.B.), Asklepios Klinik St. Georg, Hamburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Rausch","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiology (A.M., P.W., P.R., A.B., C.G., R.R.T., A.R., S.M., S.D., H.M., F.O., K.-H.K., E.W.) and Internal Medicine (A.B.), Asklepios Klinik St. Georg, Hamburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Bardyszewski","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiology (A.M., P.W., P.R., A.B., C.G., R.R.T., A.R., S.M., S.D., H.M., F.O., K.-H.K., E.W.) and Internal Medicine (A.B.), Asklepios Klinik St. Georg, Hamburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Gienapp","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiology (A.M., P.W., P.R., A.B., C.G., R.R.T., A.R., S.M., S.D., H.M., F.O., K.-H.K., E.W.) and Internal Medicine (A.B.), Asklepios Klinik St. Georg, Hamburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland Richard","family":"Tilz","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiology (A.M., P.W., P.R., A.B., C.G., R.R.T., A.R., S.M., S.D., H.M., F.O., K.-H.K., E.W.) and Internal Medicine (A.B.), 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