Incidence, epidemiology, risk factors and prognosis of atrio-esophageal fistula following percutaneous catheter ablation. An exhaustive natiowide registry

Introduction A rare but often fatal complication of atrial fibrillation (AF) ablation is the formation of an atrioesophageal fistula (AEF) whose true prevalence and risk factors remain obscure. Objective To determine incidence, epidemiology, risk factors and prognosis of AEF using a – as exhaustive as possible – nationwide survey Method All French centers performing AF ablation were identified and survey were sent concerning the habits, techniques of AF ablation and eventual cases of AEF. Results 82 of the 103 centers (80%) performing ablation of AF in France were included in the study performing 129286 ablations from 2006 (93% of the total AF ablation in France). 33 AEF were declared (26 AEF and 4 esopericardial fistula) (0.026% risk per procedure) with a stable annual incidence over time, unchanged after the advent of thermal probe. Sensititvity of CT scan for AEF diagnosis was 81%. Mortality was 60%, significantly lower in case of surgical mangement (31 vs 93%, p=0.001). No case of AEF happened after cryoablation and only two AEF occurred in redo ablation. In multivariate analysis, lack of use of contact force catheters and the realization of posterior/roof ablation lines emerged as independent factors associated with the risk of AEF with OR 23.6 (95% CI [4.5; 21]) p=0.0002 and OR 3.7 (95% CI [1.1, 13]) p=0.04) while the lack of thermal probes remained of borderline significance. Conclusion The rate of AEF after AF ablation in a nationwide and well exhaustive survey can be evaluated to 0.026% with an annual incidence remaining stable over time. A normal CT scan does not rule out the diagnosis. Prognosis remains poor with a mortality of 60% and crucially dependant of immediate surgical correction. Funding Acknowledgement Type of funding source: None

Dp-brane Dynamics and Thermalization in Type IIB Ben Ami-Kuperstein-Sonnenschein Models

We extend and complete our analysis arXiv:1608.02380 and study the induced world volume metrics and Hawking temperatures of all type IIB rotating probe Dp-branes, dual to the temperature of different flavors at finite R-charge, in the Ben Ami–Kuperstein–Sonnenschein holographic models including the effects of spontaneous conformal and chiral flavor symmetry breakdown. The model embeds type IIB probe flavor Dp-branes into the Klebanov-Witten gravity dual of conformal gauge theory, with the embedding parameter, given by the minimal radial extension of the probes, dual to the IR scale of conformal and chiral flavor symmetry breakdown. We show that when the minimal extension is positive definite, the induced world volume metrics of type IIB rotating probe branes admit thermal horizons and Hawking temperatures despite the absence of black holes in the bulk subject to the world volume and topology of the nontrivial internal cycle wrapped by the probe. We also derive the energy–stress tensor of the thermal probes and study their backreaction and energy dissipation. We show that at the IR scale the backreaction is nonnegligible and find the energy can flow from the probes to the bulk, dual to the energy dissipation from the flavor sectors into the gauge theory.

Temperature-Independent Lifetime and Thermometer Operated in a Biological Window of Upconverting NaErF4 Nanocrystals

Lifetime of lanthanide luminescence basically decreases with increasing the ambient temperature. In this work, we developed NaErF4 core–shell nanocrystals with compensation of the lifetime variation with temperature. Upconversion lifetime of various emissions remains substantially unchanged as increasing the ambient temperature, upon 980/1530 nm excitation. The concentrated dopants, leading to extremely strong interactions between them, are responsible for the unique temperature-independent lifetime. Besides, upconversion mechanisms of NaErF4 core-only and core–shell nanocrystals under 980 and 1530 nm excitations were comparatively investigated. On the basis of luminescent ratiometric method, we demonstrated the optical thermometry using non-thermally coupled 4F9/2 and 4I9/2 emissions upon 1530 nm excitation, favoring the temperature monitoring in vivo due to both excitation and emissions fall in the biological window. The formed NaErF4 core–shell nanocrystals with ultra-small particle size, highly efficient upconversion luminescence, unique temperature-independent lifetimes, and thermometry operated in a biological window, are versatile in applications such as anti-counterfeiting, time-domain manipulation, and biological thermal probes.