{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T09:08:44Z","timestamp":1793524124920,"version":"4.5.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2014,9,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Periesophageal vagal nerve injury is recognized as a rare complication in atrial fibrillation ablation procedures. We investigated the factors associated with the occurrence of symptomatic p\n              <jats:styled-content style=\"fixed-case\">eriesophageal vagal nerve injury<\/jats:styled-content>\n              after pulmonary vein antrum isolation.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Overall, 535 consecutive patients who underwent sole\n              <jats:styled-content style=\"fixed-case\">pulmonary vein antrum isolation<\/jats:styled-content>\n              were included. Point\u2010by\u2010point radiofrequency applications were applied using irrigated\u2010tip catheters under minimal sedation without esophageal temperature monitoring. In the initial 165 patients, the ablation settings for the posterior left atrium were a maximum energy of 25 to 30\u00a0W and a duration of 30\u00a0seconds. In the subsequent 370 patients, the power was additionally limited to 20 to 25\u00a0W at specific parts of the posterior\n              <jats:styled-content style=\"fixed-case\">left atrium<\/jats:styled-content>\n              where the ablation line transversed the esophagus. Symptomatic gastric hypomotility was found in 13 patients, and all were observed during the initial period (7.9%). No other collateral damage was observed. Logistic regression analysis revealed that the body mass index was the only independent predictor for identifying patients with gastric hypomotility (odds ratio 0.770; 95% confidence interval 0.643 to 0.922;\n              <jats:italic>P<\/jats:italic>\n              =0.0045) during the initial period. The prevalence of gastric hypomotility was significantly higher in the initial study period than subsequently (0 of 370, 0%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001). All except for 1 patient recovered completely with conservative treatment within 4\u00a0months after the procedure.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              P\n              <jats:styled-content style=\"fixed-case\">eriesophageal vagal nerve injury<\/jats:styled-content>\n              is more common collateral damage than direct esophageal injury in\n              <jats:styled-content style=\"fixed-case\">pulmonary vein antrum isolation<\/jats:styled-content>\n              procedures. Titrating the\n              <jats:styled-content style=\"fixed-case\">radiofrequency<\/jats:styled-content>\n              energy at specific areas where the ablation line transverses the esophagus and taking account of the body mass index might reduce occurrences not only of direct esophageal damage but also of\n              <jats:styled-content style=\"fixed-case\">periesophageal vagal nerve injury<\/jats:styled-content>\n              in\n              <jats:styled-content style=\"fixed-case\">pulmonary vein antrum isolation<\/jats:styled-content>\n              procedures.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.114.001209","type":"journal-article","created":{"date-parts":[[2014,9,24]],"date-time":"2014-09-24T06:06:27Z","timestamp":1411538787000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":40,"title":["Factors Associated With Periesophageal Vagal Nerve Injury After Pulmonary Vein Antrum Isolation"],"prefix":"10.1161","volume":"3","author":[{"given":"Shinsuke","family":"Miyazaki","sequence":"first","affiliation":[{"name":"Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Ibaraki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Taniguchi","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Ibaraki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeki","family":"Kusa","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Ibaraki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Komatsu","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Ibaraki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noboru","family":"Ichihara","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Ibaraki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takamitsu","family":"Takagi","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Ibaraki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Iwasawa","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Ibaraki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akio","family":"Kuroi","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Ibaraki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Ibaraki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Hachiya","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Ibaraki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenzo","family":"Hirao","sequence":"additional","affiliation":[{"name":"Heart Rhythm Center, Tokyo Medical and Dental University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshito","family":"Iesaka","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Ibaraki, 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