Arrhythmias & electrophysiologyCohort study
Incidence and predictors of thermal oesophageal and vagus nerve injuries in Ablation Index-guided high-power-short-duration ablation of atrial fibrillation: a prospective study
- Prospective observational study
- single-centre
- machine learning analysis
Authors' conclusion
The low thermal lesion's rate (7.6%) during Ablation Index-guided HPSD ablation for atrial fibrillation is noteworthy.
Study context
- Population
- Patients undergoing Ablation Index-guided high-power-short-duration (HPSD) ablation for AF with subsequent oesophagogastroduodenoscopy, Leipzig Heart Centre, Germany, Feb 2021–Aug 2023; multiple prior ablations excluded
- Participants
- 238 patients
- Exposure
- Thermal injury vs no thermal injury
- Thermal injuryn = 18
- Outcome
- Incidence and predictors of thermal oesophageal and vagus nerve injuries
Main finding
As reported in the abstract
Thermal injuries
| Group | Value | Oesophagus | Vagus nerve | Both | Oesophageal erythemata | Ulcers | Fistula |
|---|---|---|---|---|---|---|---|
| Thermal injury | 7.6% | nine | eight | one | eight | two | no |
Observational data: associations, not effects.
Further findings
Posterior wall mean force
P = 0.022
Left atrium–oesophagus distance
P = 0.012
Atrial surface area
P = 0.032
| Outcome | Thermal injury | No thermal injury | P value |
|---|---|---|---|
| Posterior wall ablation point quantity | mean 61.50 (SD 20.45) | mean 48.16 (SD 19.60) | P = 0.007 |
| Posterior wall total Ablation Index | mean 24 114 (SD 8765) | mean 18 894 (SD 7863) | P = 0.008 |
| Posterior wall maximum Ablation Index | mean 499 (SD 95) | mean 473 (SD 44) | P = 0.04 |
Oesophagus location
- Oesophagus location not significantly correlated with thermal injury
Original publication
Incidence and predictors of thermal oesophageal and vagus nerve injuries in Ablation Index-guided high-power-short-duration ablation of atrial fibrillation: a prospective study. Europace. Published 22 April 2024. doi:10.1093/europace/euae107
Summarised from the published abstract; every number is checked against it