Device Moves Esophagus for Cardiac Ablation Procedure

Researchers at the Ohio State University Wexner Medical Center have developed a medical device that is intended to improve patient safety during cardiac ablation procedures to treat atrial fibrillation (AFib). At present, the esophagus can lie very near to the target tissue during cardiac ablation, leading to esophageal injury in many patients. This device is advanced down the esophagus and applies gentle suction to the esophageal wall to move the esophagus gently to one side, away from the ablation equipment, creating a small space in which the surgeon can perform the procedure more safely.

Atrial fibrillation is typically treated through the application of heat or cold to the part of the heart that is the source of the problem. However, the esophagus lies pretty close as well, often just a couple of millimeters away. If the destructive power of the ablation affects the esophagus, it can cause an esophageal injury. In rare cases this can lead to an atrioesophageal fistula, which is essentially a hole between the heart and esophagus that can prove fatal.

To address this, these researchers have developed a new medical device, called ESOlution, that can gently move the esophagus out of harm’s way during cardiac ablation procedures. The technology consists of a long stick that can be advanced down the esophagus until it reaches the correct region, and then apply suction to the esophageal wall before moving the entire segment out of the way.

“It has been frustrating to not have an effective method to protect the esophagus while delivering the ablation energy at the desired location,” said Emile Daoud, a researcher involved in the project. “By using suction force, we’re able to pull in the esophagus and then move the entire segment to the side by only about an inch. This creates a safe pathway to deliver the treatment.”

So far, the researchers have tested the device in a clinical trial of 120 cardiac ablation patients. The results have been encouraging, and the researchers report that without the device, over a third of the patients demonstrated esophageal injuries, but this was reduced to less than 5% when the device was employed.

“How to safely protect the esophagus has been a well-recognized problem for at least 15 years,” said Daoud. “There are several techniques such as measuring the temperature inside the esophagus and using ultrasound or CT imaging to see where it’s located, but we still have esophageal injuries. This device is effective, inexpensive and connects to a vacuum suction, which is already in every electrophysiology laboratory.”

See a video about the technology: