{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T19:28:41Z","timestamp":1789241321582,"version":"build-2803163510"},"reference-count":31,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T00:00:00Z","timestamp":1674086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Safety of pulmonary vein isolation (PVI) has been established in clinical studies. However, despite prevention efforts the incidence of damage to (peri)\u2010esophageal tissue has not decreased, and the pathophysiology is incompletely understood. Damage to vagal nerve branches may be involved in lesion progression to atrio\u2010esophageal fistula. Using electrogastrography, we assessed the incidence of periesophageal vagal nerve injury (VNI) following atrial fibrillation ablation and its association with procedural parameters and endoscopic results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients were studied using electrogastrography, endoscopy, and endoscopic ultrasound before and after cryoballoon (CB) or radiofrequency (RF) PVI. The incidence of ablation\u2010induced neuropathic pattern (indicating VNI) in pre\u2010 and postprocedural electrogastrography was assessed and correlated with endoscopic results and ablation data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between February 2021 und January 2022, 85 patients (67\u2009\u00b1\u200910 years, 53% male) were included, 33 were treated with CB and 52 with RF (38 with moderate power moderate duration [25\u201330\u2009W] and 14 with high power short duration [50\u2009W]). Ablation\u2010induced VNI was detected in 27\/85 patients independent of the energy form. Patients with VNI more frequently had postprocedural endoscopically detected pathology (8% mucosal esophageal lesions, 36% periesophageal edema, 33% food retention) but there was incomplete overlap. Pre\u2010existing esophagitis increased the likelihood of VNI. Ablation data and esophageal temperature data did not predict VNI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>PVI\u2010induced VNI is quite common and independent of ablation energy source. VNI is part of (peri)\u2010esophageal damage and only partially overlaps with endoscopic findings. VNI\u2010associated acidic reflux may be involved in the complex pathophysiology of esophageal lesion progression to fistula.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15820","type":"journal-article","created":{"date-parts":[[2023,1,14]],"date-time":"2023-01-14T20:11:38Z","timestamp":1673727098000},"page":"583-592","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Pulmonary vein isolation\u2010induced vagal nerve injury and gastric motility disorders detected by electrogastrography: The side effects of pulmonary vein isolation in atrial fibrillation (SEPIA) study"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1532-1934","authenticated-orcid":false,"given":"Dirk","family":"Grosse Meininghaus","sequence":"first","affiliation":[{"name":"Department of Cardiology Carl\u2010Thiem\u2010Hospital Cottbus Cottbus Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Freund","sequence":"additional","affiliation":[{"name":"Carl\u2010Thiem\u2010Hospital Cottbus Thiem Research Cottbus Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3913-6821","authenticated-orcid":false,"given":"Tobias","family":"Kleemann","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Carl\u2010Thiem\u2010Hospital Cottbus Cottbus Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johann Christoph","family":"Geller","sequence":"additional","affiliation":[{"name":"Zentralklinik Bad Berka, Division of Cardiology Arrhythmia Section Bad Berka Germany"},{"name":"Otto\u2010von\u2010Guericke University School of Medicine Magdeburg Magdeburg 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