Esophageal monitoring
An esophageal monitoring device includes a camera and, optionally, one or more lights to enable visualization of an interior of a subject's esophagus. Visualization of the interior of the subject's esophagus before and after a left atrial ablation procedure may enable a healthcare provider to determine whether or not the left atrial ablation procedure has damaged the subject's esophagus before the subject experiences any symptoms of such damage. An esophageal monitoring device may also include sensors and/or markers that enable a determination of its location within a subject's esophagus. Such an esophageal monitoring device may be configured for three-dimensional mapping, and enable the generation of an accurate three-dimensional map of the physical relationship between a subject's esophagus and the left atrium of his or her heart. Methods of monitoring a subject's esophagus while a left atrial ablation procedure is being conducted on the subject's hear are also disclosed.
1. A method for evaluating a state of an esophagus before, during, and after an ablation procedure conducted on a left atrium of a heart, the method comprising:
visualizing an inner surface of the esophagus while introducing an esophageal monitoring device into the esophagus;
conducting the ablation procedure within the left atrium of the heart;
monitoring a condition of the inner surface of a portion of the esophagus adjacent to the left atrium of the heart while conducting the ablation procedure; and
visualizing the inner surface of the portion of the esophagus adjacent to the left atrium of the heart while withdrawing the esophageal monitoring device from the esophagus.
2. The method of claim 1 , wherein:
introducing the esophageal monitoring device into the esophagus comprises:
introducing a temperature probe carrying a plurality of temperature sensors in an area array into the esophagus; and
positioning the temperature probe against the portion of the inner surface of the esophagus adjacent to the left atrium; and
monitoring the condition of the inner surface of the portion of the esophagus adjacent to the left atrium of the heart while conducting the ablation procedure comprises:
monitoring temperatures of the inner surface of the portion of the esophagus adjacent to the left atrium at a plurality of locations adjacent to which the plurality of temperature sensors are positioned.
3. The method of claim 2 , wherein introducing the esophageal monitoring device into the esophagus further comprises:
unfolding branches of the temperature probe when the branches of the temperature probe are located adjacent to the portion of the esophagus adjacent to the left atrium.
4. The method of claim 1 , wherein:
introducing the esophageal monitoring device into the esophagus comprises:
introducing a pressure probe carrying a plurality of pressure sensors in an area array into the esophagus; and
positioning the pressure probe against the portion of the inner surface of the esophagus adjacent to the left atrium; and
monitoring the condition of the inner surface of the portion of the esophagus adjacent to the left atrium of the heart while conducting the ablation procedure comprises:
monitoring pressure applied to the portion of the inner surface of the esophagus adjacent to the left atrium of the heart by the left atrium at a plurality of locations adjacent to which the plurality of pressure sensors are positioned.
5. The method of claim 4 , wherein introducing the esophageal monitoring device into the esophagus further comprises:
unfolding branches of the pressure probe when the branches of the pressure probe are located adjacent to the portion of the esophagus adjacent to the left atrium.
6. The method of claim 1 , wherein visualizing the inner surface of the esophagus while introducing the esophageal monitoring device into the esophagus and/or visualizing the inner surface of the portion of the esophagus adjacent to the left atrium of the heart while withdrawing the esophageal monitoring device from the esophagus comprises visualizing the inner surface of the esophagus at fixed distance intervals.
7. The method of claim 6 , wherein visualizing the inner surface of the esophagus while introducing the esophageal monitoring device into the esophagus and/or visualizing the inner surface of the portion of the esophagus adjacent to the left atrium of the heart while withdrawing the esophageal monitoring device from the esophagus comprises visualizing the inner surface of the esophagus at intervals of about 5 mm.
8. The method of claim 1 , wherein visualizing the inner surface of the esophagus while introducing the esophageal monitoring device into the esophagus and visualizing the inner surface of the portion of the esophagus adjacent to the left atrium of the heart while withdrawing the esophageal monitoring device from the esophagus comprise obtaining a plurality of still images of the inner surface of the esophagus.
9. The method of claim 1 , wherein visualizing the inner surface of the esophagus comprises illuminating the inner surface of the esophagus with at least one wavelength of light that will reveal trauma to the inner surface of the esophagus earlier than white light will reveal the trauma.
10. The method of claim 1 , further comprising:
comparing a condition of the inner surface of the esophagus while introducing the esophageal monitoring device into the esophagus to a condition of the inner surface of the esophagus while withdrawing the esophageal monitoring device from the esophagus.
11. The method of claim 10 , wherein comparing comprises determining an effect of the ablation procedure on the inner surface of the esophagus, including an inner surface of the portion of the esophagus located adjacent to the left atrium of the heart.
12. The method of claim 10 , wherein comparing comprises determining an effect of introducing the esophageal monitoring device into the esophagus and/or removing the esophageal monitoring device from the esophagus on the inner surface of the esophagus.
13. The method of claim 10 , further comprising:
addressing any damage to the esophagus.
14. A method for evaluating a state of an esophagus during and after a medical procedure, comprising:
conducting the medical procedure;
monitoring a condition of an inner surface of a portion of the esophagus with an esophageal monitoring device while conducting the medical procedure; and
visualizing the inner surface of the portion of the esophagus while withdrawing the esophageal monitoring device from the esophagus.
15. The method of claim 14 , further comprising:
visualizing the inner surface of the portion of the esophagus while introducing the esophageal monitoring device into the esophagus.
16. The method of claim 15 , further comprising:
comparing a condition of the inner surface while monitoring the condition of the inner surface to a condition of the inner surface while introducing the esophageal monitoring device.
17. The method of claim 16 , wherein comparing comprises determining an effect of the medical procedure on the inner surface.
18. The method of claim 15 , further comprising:
comparing a condition of the inner surface while withdrawing the esophageal monitoring device to a condition of the inner surface while monitoring the condition of the inner surface and/or to a condition of the inner surface while introducing the esophageal monitoring device.
19. The method of claim 18 , wherein comparing comprises determining an effect of the medical procedure on the inner surface.
20. The method of claim 15 , further comprising:
determining an effect of introducing the esophageal monitoring device and/or withdrawing the esophageal monitoring device on the inner surface.