Arrhythmias & electrophysiology
European Heart Rhythm Association survey on the perceived severity of complications in atrial fibrillation ablation: development of a standardized scoring model
Authors' conclusion
The EHRA complication severity score provides a standardized, quantitative ranking of AF ablation complications, identifying periprocedural death and AEF as the most severe events.
Study context
- Population
- European electrophysiologists scoring perceived severity of atrial fibrillation (AF) ablation complications (0 = no complication to 100 = procedural death)105 excluded (incomplete)
- Participants
- 300 electrophysiologists
- Outcome
- Perceived complication severity score (0–100)
Methodological detailsphysician-based online survey, Conducted by the Scientific Initiative Committee of European Heart Rhythm Association (EHRA)
- Physician-based online survey
- Conducted by the Scientific Initiative Committee of EHRA
Main finding
As reported in the abstract
Median severity scores (IQR), highest-ranked complications
- Unexplained periprocedural death
- 90, IQR 50-100
- Atrio-oesophageal fistula (AEF)
- 92, 80-100
- Procedural stroke
- 80, 59-89
- Tamponade requiring surgery
- 70, 80-83
- Phrenic nerve palsy at discharge
- 49, 25-67
- Tamponade treated with pericardial puncture
- 50, 25-70
- Periprocedural TIA
- 50, 25-70
Observational data: associations, not effects.
Further findings
Effect of institutional infrastructure (cardiac surgery, stroke units) on scoring
- No impact on the scoring
Respondents who have experienced each complication
- Cardiac tamponade
- 89%
- Procedural stroke
- 53%
- AEF
- 25%
EHRA AF ablation safety score applied retrospectively to existing studies
- Trend towards improved AF ablation safety over time
Original publication
European Heart Rhythm Association survey on the perceived severity of complications in atrial fibrillation ablation: development of a standardized scoring model. Europace. Published 20 November 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →