IntroductionThe use of esophageal temperature monitoring (ETM) for the prevention of esophageal injury during atrial fibrillation (AF) ablation is often advocated. However, evidence supporting its use is scarce and controversial. We therefore aimed to review the evidence assessing the efficacy of ETM for the prevention of esophageal injury.MethodsWe performed a meta‐analysis and systematic review of the available literature from inception to December 31, 2022. All studies comparing the use of ETM, versus no ETM, during radiofrequency (RF) AF ablation and which reported the incidence of endoscopically detected esophageal lesions (EDELs) were included.ResultsEleven studies with a total of 1112 patients undergoing RF AF ablation were identified. Of those patients, 627 were assigned to ETM (56%). The overall incidence of EDELs was 9.8%. The use of ETM during AF ablation was associated with a non significant increase in the incidence of EDELs (12.3% with ETM, vs. 6.6 % without ETM, odds ratio, 1.44, 95%CI, 0.49, 4.22, p = .51, I2 = 72%). The use of ETM was associated with a significant increase in the energy delivered specifically on the posterior wall compared to patients without ETM (mean power difference: 5.13 Watts, 95% CI, 1.52, 8.74, p = .005).ConclusionsThe use of ETM does not reduce the incidence of EDELs during RF AF ablation. The higher energy delivered on the posterior wall is likely attributable to a false sense of safety that may explain the lack of benefit of ETM. Further randomized controlled trials are needed to provide conclusive results.

中文翻译：

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使用食管温度监测预防房颤导管消融期间的食管病变：系统评价和荟萃分析

简介经常提倡使用食管温度监测（ETM）来预防心房颤动（AF）消融期间的食管损伤。然而，支持其使用的证据很少且存在争议。因此，我们的目的是回顾评估 ETM 预防食管损伤功效的证据。方法我们对从成立到 2022 年 12 月 31 日的现有文献进行了荟萃分析和系统回顾。所有研究都比较了 ETM 的使用与不使用 ETM 的情况。 ETM，在射频 (RF) AF 消融期间报告了内窥镜检测到的食管病变 (EDEL) 的发生率。结果 11 项研究共纳入 1112 名接受 RF AF 消融的患者。在这些患者中，627 名患者被分配至 ETM（56%）。 EDEL 的总体发生率为 9.8%。 AF 消融期间使用 ETM 与 EDEL 发生率非显着增加相关（使用 ETM 为 12.3%，不使用 ETM 为 6.6%，比值比，1.44，95%CI，0.49，4.22，p= .51,我2= 72%）。与未使用 ETM 的患者相比，使用 ETM 后壁传递的能量显着增加（平均功率差异：5.13 瓦，95% CI，1.52、8.74、p= .005)。结论ETM 的使用不会降低 RF AF 消融期间 EDEL 的发生率。后壁传递的较高能量可能归因于错误的安全感，这可以解释 ETM 缺乏益处的原因。需要进一步的随机对照试验来提供结论性的结果。