Evaluation of a Novel Esophageal Luminal Device and its Impact on the Left Atrial-Esophageal Relationship: A Cadaveric Imaging Study
Bibliographic record
Abstract
Background: Atrial-esophageal fistula (AEF) is a complication of catheter ablation procedures for atrial fibrillation. Esophageal luminal devices (ELDs) may potentially mitigate the risk of developing an AEF by preventing thermal injury, yet their impact on the esophagus-left atrium (LA) relationship is unknown. Objective: This study will investigate the changes, if any, that occur in the LA-esophageal relationship upon insertion of an ELD prototype. Methods: Twelve fresh cadaveric torsos were scanned, via computed tomography (CT), with and without an ELD. Esophageal width and anterior-posterior dimension (APD) were digitally measured and compared within specimens. 3D reconstructions of the LA and esophagus were used for a spatial analysis of their relationship. Translational movements of the esophagus were also noted from reconstructions. Results: Minimal esophageal translation was noted in seven (58%) specimens, leftwards deviation in three (25%) specimens, and posterior deviation in two (17%) specimens. One or both of esophageal width and APD increased in eleven (92%) specimens but did not always lead to an increase in surface contact at the posterior LA. In addition, leftwards or posterior deviation of the esophagus was associated with a reduction in surface contact, with the latter reducing contact completely. Furthermore, the anterior esophagus-LA distance was a good predictor of surface contact changes. Conclusions: This study is the first to provide a comprehensive understanding of changes in the esophagus-LA relationship as it pertains to the use of ELDs. Heterogeneity in morphological and translational changes of the esophagus suggest the need for considering anatomical variations in the design of medical devices.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".