{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:09:14Z","timestamp":1792642154435,"version":"4.5.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"vor","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Atrial fibrillation (AF) ablation is associated with complications. These are sometimes categorized as mild or severe based on unspecified criteria. We conducted a survey of European electrophysiologists (EPs) to rank the perceived complication severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>A physician-based survey was conducted by the Scientific Initiative Committee of the European Heart Rhythm Association (EHRA). An online questionnaire was created asking EPs to score a list of complications on a scale from 0 (no complication) to 100 (procedural death). Three hundred respondents participated in the survey; however, 105 were excluded due to incomplete responses. Unexplained periprocedural death (90, interquartile range 50\u2013100), atrio-oesophageal fistula (AEF 92, 80\u2013100), procedural stroke (80, 59\u201389), and tamponade requiring surgery (70, 80\u201383) were the complications associated with highest scores. Among the intermediate complications, phrenic nerve palsy at discharge (49, 25\u201367) was ranked similarly to tamponade treated with pericardial puncture (50, 25\u201370) or periprocedural transient ischaemic attack (50, 25\u201370). Institutional infrastructural features such as cardiac surgery or stroke units had no impact on the scoring. Most respondents (89%) have experienced cardiac tamponade, procedural stroke (53%), and AEF (25%). When applied retrospectively to existing studies, the proposed EHRA AF ablation safety score demonstrated a trend towards improved AF ablation safety over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The EHRA complication severity score provides a standardized, quantitative ranking of AF ablation complications, identifying periprocedural death and AEF as the most severe events. Based on the findings, we propose a novel EHRA AF ablation safety score that may contribute to a more objective safety comparison of AF ablation trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/europace\/euaf254","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T13:02:06Z","timestamp":1763038926000},"source":"Crossref","is-referenced-by-count":11,"title":["European Heart Rhythm Association survey on the perceived severity of complications in atrial fibrillation ablation: development of a standardized scoring model"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0282-4658","authenticated-orcid":false,"given":"Stefano","family":"Bordignon","sequence":"first","affiliation":[{"name":"Electrophysiology Unit, Klinik f\u00fcr Innere Medizin I, Varisano Klinikum Frankfurt H\u00f6chst , Gotenstra\u00dfe 6-8, 65929 Frankfurt am Main ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5425-7739","authenticated-orcid":false,"given":"Mark T","family":"Mills","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Liverpool Heart & Chest Hospital NHS Foundation Trust , Liverpool ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0219-7612","authenticated-orcid":false,"given":"Piotr","family":"Futyma","sequence":"additional","affiliation":[{"name":"St. Joseph's Heart Rhythm Center and University of Rzesz\u00f3w , Rzesz\u00f3w ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1807-4860","authenticated-orcid":false,"given":"Arian","family":"Sultan","sequence":"additional","affiliation":[{"name":"Electrophysiology Unit at Asklepios Clinic St. Georg , Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6818-6396","authenticated-orcid":false,"given":"Andreas","family":"Metzner","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Kardiologie, University Clinic Eppendorf , Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8574-9421","authenticated-orcid":false,"given":"Federico","family":"Migliore","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic Vascular Sciences and Public Health, University of Padua , Padua ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4322-1183","authenticated-orcid":false,"given":"Laura","family":"Perrotta","sequence":"additional","affiliation":[{"name":"Careggi University Hospital Electrophysiology Unit, , Firenze ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6864-3999","authenticated-orcid":false,"given":"Ante","family":"Anic","sequence":"additional","affiliation":[{"name":"Electrophysiology Unit, University Hospital Split (KBC Split) ,","place":["Croatia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1737-1903","authenticated-orcid":false,"given":"Jos\u00e9 Luis","family":"Merino","sequence":"additional","affiliation":[{"name":"Arrhythmia and Robotic Electrophysiology Unit, Hospital Universitario La Paz de Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8965-8495","authenticated-orcid":false,"given":"Helmut","family":"P\u00fcrerfellner","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ordensklinikum Linz Elisabethinen , Linz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2355-6015","authenticated-orcid":false,"given":"Julian K R","family":"Chun","sequence":"additional","affiliation":[{"name":"Med. 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