Esophageal heating characteristics of very high-power short duration radiofrequency ablation in a myocardial phantom model

Esophageal heating characteristics of very high-power short duration radiofrequency ablation in a myocardial phantom model | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Esophageal heating characteristics of very high-power short duration radiofrequency ablation in a myocardial phantom model Shayekh Abedin, Xingzhou Liu, Amir H. Pour, Michael A. Barry, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8524974/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 16 Apr, 2026 Read the published version in Journal of Interventional Cardiac Electrophysiology → Version 1 posted You are reading this latest preprint version Abstract Background: Very high short duration radiofrequency catheter ablation can rapidly achieve pulmonary vein isolation, however safety to the esophagus during posterior left atrial ablation is uncertain. This study looked to characterise lesion formation and esophageal thermal effects with very high-power short duration (vHPSD), and to compare it with high power short duration (HPSD) and low power long duration (LPLD) radiofrequency ablation, using esophageal heating and esophageal temperature probe (ETP) measurements. Methods: A thermochromic gel phantom model of posterior left atrial wall with an embedded ETP was used to assess heating kinetics during radiofrequency ablation (RFA). RFA was performed at 30W/20s (LPLD), 50W/5s (HPSD), 90W/3 and 90W/4s (vHPSD). Continuous ETP temperature was recorded, and thermal mapping of esophageal temperature was performed. Results: 90W/3s (5.17±0.01 mm) and 90W/4s (5.62±0.06 mm) produced broader lesions than 50W/5s (4.17± 0.11 mm, p<0.0001) and 30W/20 s (3.95±0.38 mm, p<0.01), with similar depth. The ETP underestimated the peak esophageal temperature across all ablation settings with the highest temperature disparity in 30W/20s (3.70±0.60°C, p=0.0007), 90W/3s (2.87±0.06°C, p<0.0001) and 90W/4s (2.53±0.25°C, p=0.0016) groups. Thermal latency was greatest in 90W/4s, followed by 90W/3s, 50W/5s and 30W/20s. Consecutive applications of RFA energy led to heat accumulation and greater esophageal heating, most marked with 90W/4s (41.13±0.12°C), and 30W/20s (40.90±0.10°C). Conclusion. vHPSD produces broader lesions with comparable depth which may result in improved PVI lesion contiguity, however, repeated successive applications with vHPSD may lead to greater esophageal heating and inaccurate ETP monitoring due to temperature disparities and thermal latency. Atrial Fibrillation Radiofrequency Ablation Very High Power Short Duration Esophageal Injury Esophageal Temperature Ablation Biophysics Full Text Additional Declarations Competing interest reported. PQ has received honoraria from Johnson and Johnson, Biotronik, and Abbott Medical. SPT has received honoraria from Biotronik, Boston Scientific, and Johnson and Johnson. PQ was supported by a National Health and Medical Research Council (NHMRC) investigator grant (2018376), Heart Foundation Future Leader Fellowship with Paul Korner Award (106780), and a McCusker Charitable Foundation grant. XL was supported by a Heart Foundation PhD Scholarship (108309). Cite Share Download PDF Status: Published Journal Publication published 16 Apr, 2026 Read the published version in Journal of Interventional Cardiac Electrophysiology → Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8524974","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":575571217,"identity":"87a31fc6-94df-46a2-9d9c-7ec25968d3da","order_by":0,"name":"Shayekh Abedin","email":"","orcid":"","institution":"Westmead Hospital","correspondingAuthor":false,"prefix":"","firstName":"Shayekh","middleName":"","lastName":"Abedin","suffix":""},{"id":575571218,"identity":"9eba5289-8b71-499c-ac3f-aee25362e81b","order_by":1,"name":"Xingzhou Liu","email":"","orcid":"","institution":"Westmead Hospital","correspondingAuthor":false,"prefix":"","firstName":"Xingzhou","middleName":"","lastName":"Liu","suffix":""},{"id":575571219,"identity":"2ee912c0-2548-4586-91fa-b4792882b14c","order_by":2,"name":"Amir H. 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PQ has received honoraria from Johnson and Johnson, Biotronik, and Abbott Medical. SPT has received honoraria from Biotronik, Boston Scientific, and Johnson and Johnson. PQ was supported by a National Health and Medical Research Council (NHMRC) investigator grant (2018376), Heart Foundation Future Leader Fellowship with Paul Korner Award (106780), and a McCusker Charitable Foundation grant. XL was supported by a Heart Foundation PhD Scholarship (108309).","formattedTitle":"Esophageal heating characteristics of very high-power short duration radiofrequency ablation in a myocardial phantom model","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Atrial Fibrillation, Radiofrequency Ablation, Very High Power Short Duration, Esophageal Injury, Esophageal Temperature, Ablation Biophysics","lastPublishedDoi":"10.21203/rs.3.rs-8524974/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8524974/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003eVery high short duration radiofrequency catheter ablation can rapidly achieve pulmonary vein isolation, however safety to the esophagus during posterior left atrial ablation is uncertain. This study looked to characterise lesion formation and esophageal thermal effects with very high-power short duration (vHPSD), and to compare it with high power short duration (HPSD) and low power long duration (LPLD) radiofrequency ablation, using esophageal heating and esophageal temperature probe (ETP) measurements.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003eA thermochromic gel phantom model of posterior left atrial wall with an embedded ETP was used to assess heating kinetics during radiofrequency ablation (RFA). RFA was performed at 30W/20s (LPLD), 50W/5s (HPSD), 90W/3 and 90W/4s (vHPSD). Continuous ETP temperature was recorded, and thermal mapping of esophageal temperature was performed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e90W/3s (5.17±0.01 mm) and 90W/4s (5.62±0.06 mm) produced broader lesions than 50W/5s (4.17± 0.11 mm, p\u0026lt;0.0001) and 30W/20 s (3.95±0.38 mm, p\u0026lt;0.01), with similar depth. The ETP underestimated the peak esophageal temperature across all ablation settings with the highest temperature disparity in 30W/20s (3.70±0.60°C, p=0.0007), 90W/3s (2.87±0.06°C, p\u0026lt;0.0001) and 90W/4s (2.53±0.25°C, p=0.0016) groups. Thermal latency was greatest in 90W/4s, followed by 90W/3s, 50W/5s and 30W/20s. Consecutive applications of RFA energy led to heat accumulation and greater esophageal heating, most marked with 90W/4s (41.13±0.12°C), and 30W/20s (40.90±0.10°C).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion. \u003c/strong\u003evHPSD produces broader lesions with comparable depth which may result in improved PVI lesion contiguity, however, repeated successive applications with vHPSD may lead to greater esophageal heating and inaccurate ETP monitoring due to temperature disparities and thermal latency.\u003c/p\u003e","manuscriptTitle":"Esophageal heating characteristics of very high-power short duration radiofrequency ablation in a myocardial phantom model","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-20 10:57:13","doi":"10.21203/rs.3.rs-8524974/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e437ce67-fd61-4c7f-bf75-0ab083234758","owner":[],"postedDate":"January 20th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-20T16:09:38+00:00","versionOfRecord":{"articleIdentity":"rs-8524974","link":"https://doi.org/10.1007/s10840-026-02318-6","journal":{"identity":"journal-of-interventional-cardiac-electrophysiology","isVorOnly":false,"title":"Journal of Interventional Cardiac Electrophysiology"},"publishedOn":"2026-04-16 15:59:38","publishedOnDateReadable":"April 16th, 2026"},"versionCreatedAt":"2026-01-20 10:57:13","video":"","vorDoi":"10.1007/s10840-026-02318-6","vorDoiUrl":"https://doi.org/10.1007/s10840-026-02318-6","workflowStages":[]},"version":"v1","identity":"rs-8524974","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8524974","identity":"rs-8524974","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}