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

Wolff, C; Langenhan, K; Wolff, M; Efimova, E; Zachäus, M; Darma, A; Dinov, B; Seewöster, T; Nedios, S; Bertagnolli, L; Wolff, J; Paetsch, I; Jahnke, C; Bollmann, A; Hindricks, G; Bode, K; Halm, U; Arya, A

doi:10.1093/europace/euae107

Arrhythmias & electrophysiology

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

EuropacePublished 22 Apr 2024Prospective observational study

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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

Methodological detailssingle-centre, machine learning analysis

Single-centre
Machine learning analysis

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

Thermal injury

Value7.6%

Oesophagusnine

Vagus nerveeight

Bothone

Oesophageal erythemataeight

Ulcerstwo

Fistulano

Observational data: associations, not effects.

Further findings

Posterior wall mean force

P = 0.022

Thermal injurymean 15.8 gSD 3.9

No thermal injurymean 13.6 gSD 3.9

Left atrium–oesophagus distance

P = 0.012

Thermal injurymean 3.0 mmSD 1.5

No thermal injurymean 4.4 mmSD 2.1

Atrial surface area

P = 0.032

Thermal injurymean 24.9 cm²SD 6.5

No thermal injurymean 29.5 cm²SD 7.5

Outcome	Thermal injury	No thermal injury	P value
Posterior wall ablation point quantityMean	61.50 (SD 20.45)	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 IndexMean	499 (SD 95)	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

Read the original article ↗

Composed by AI from the published abstract and checked against it. How Briefs are made →