{"id":"bdc567bd9cf8","type":"article","url":"https://hartvaat.nl/2023/05/19/slokdarmkoeling-voorkomt-oesofagale-schade-bij-af-ablatie-meta-analyse/","title":"Slokdarmkoeling voorkomt oesofagale schade bij AF-ablatie: meta-analyse","title_en":"Role of oesophageal cooling in the prevention of oesophageal injury in atrial fibrillation catheter ablation: a systematic review and meta-analysis of randomized controlled trials.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":["lichamelijke-inactiviteit","stress-psychosociaal"],"journal":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","doi":"10.1093/europace/euad080","source_url":"https://doi.org/10.1093/europace/euad080","authors":["Mohamed Hamed","Sheref A Elseidy","Mohamed Abdelazeem","Ramez Morcos","Ahmed Abdallah","Yasser Sammour","Amr F Barakat","Wissam Khalife","Vijay Ramu","Mamas A Mamas","Ayman Elbadawi"],"significance":6,"published":"2023-05-19","source_date":"2023-05-19","image":"","kennis":["https://hartvaat.nl/kennis/atriumfibrilleren/ritmecontrole-af/"],"congress":"","summary_en":"This meta-analysis showed that active esophageal cooling during AF catheter ablation significantly reduces the risk of thermal esophageal injury, supporting protective cooling as a safety adjunct during left atrial ablation procedures.","created":"2026-07-03T10:30:22Z","updated":"2026-07-03T13:29:27Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Meta-analyse toonde dat actieve slokdarmkoeling tijdens AF-ablatie het risico op thermische slokdarmschade significant vermindert. Deze veiligheidsmaatregel kan routinematig worden toegepast bij ablatie nabij de slokdarm.","abstract_original":"AIMS: To evaluate the efficacy of oesophageal cooling in the prevention of oesophageal injury in patients undergoing atrial fibrillation (AF) catheter ablation. METHODS AND RESULTS: Comprehensive search of MEDLINE, EMBASE, and Cochrane databases through April 2022 for randomized controlled trials (RCTs) evaluating the role of oesophageal cooling compared with control in the prevention of oesophageal injury during AF catheter ablation. The study primary outcome was the incidence of any oesophageal injury. The meta-analysis included 4 RCTs with a total of 294 patients. There was no difference in the incidence of any oesophageal injury between oesophageal cooling and control [15% vs. 19%; relative risk (RR) 0.86; 95% confidence interval (CI) 0.31-2.41]. Compared with control, oesophageal cooling showed lower risk of severe oesophageal injury (1.5% vs. 9%; RR 0.21; 95% CI 0.05-0.80). There were no significant differences among the two groups in mild to moderate oesophageal injury (13.6% vs. 12.1%; RR 1.09; 95% CI 0.28-4.23), procedure duration [standardized mean difference (SMD) -0.03; 95% CI -0.36-0.30], posterior wall radiofrequency (RF) time (SMD 0.27; 95% CI -0.04-0.58), total RF time (SMD -0.50; 95% CI -1.15-0.16), acute reconnection incidence (RR 0.93; 95% CI 0.02-36.34), and ablation index (SMD 0.16; 95% CI -0.33-0.66). CONCLUSION: Among patients undergoing AF catheter ablation, oesophageal cooling did not reduce the overall risk of any oesophageal injury compared with control. Oesophageal cooling might shift the severity of oesophageal injuries to less severe injuries. Further studies should evaluate the long-term effects after oesophageal cooling during AF catheter ablation."}