Abstract: Method and apparatus are disclosed for esophageal heat transfer devices and methods for cardiac tissue ablation procedures. An exemplary method includes collecting esophageal data via one or more sensing elements of an esophageal heat transfer device positioned within an esophagus of the patient. The exemplary method includes determining, based on the esophageal data and/or operator selected power setting, a temperature setting and/or a flow rate setting for fluid flowing through the esophageal heat transfer device to maintain a target temperature of esophageal tissue adjacent to the ablation site via a heat transfer region. The exemplary method includes adjusting, via the controller, a fluid source to provide the fluid to the esophageal heat transfer device at the temperature setting and/or a flow rate setting.