BACKGROUND: Ablation of atrial fibrillation is generally considered safe and effective. However, atrial-esophageal fistulas have recently been reported as a rare but fatal complication. OBJECTIVE: To describe 9 patients with atrial-esophageal fistulas after ablation for atrial fibrillation. DESIGN: Retrospective case series. SETTING: Institutions where cardiologists performed atrial fibrillation ablation procedures. PATIENTS: 9 patients with atrial-esophageal fistulas after atrial fibrillation ablation. MEASUREMENTS: Demographic characteristics, mortality, presenting signs and symptoms, and days to presentation. RESULTS: Patients presented a mean of 12.3 days (range, 10 to 16 days) after their procedures. Nonspecific symptoms included fever, leukocytosis, and neurologic abnormalities. All patients died. Only 4 patients received correct diagnoses before death, although all patients presented to a physician. In 3 patients, surgical repair was attempted. LIMITATIONS: Few physicians reported cases, and only approximate numbers of procedures performed by the physicians are known. Thus, the authors could not estimate the incidence of atrial-esophageal fistulas after ablation. CONCLUSIONS: Formation of atrial-esophageal fistulas is a rare but potentially devastating complication of atrial fibrillation ablation. This disorder may have an indolent presentation and may mimic other disease states, such as stroke or sepsis.
BACKGROUND: Ablation of atrial fibrillation is generally considered safe and effective. However, atrial-esophageal fistulas have recently been reported as a rare but fatal complication. OBJECTIVE: To describe 9 patients with atrial-esophageal fistulas after ablation for atrial fibrillation. DESIGN: Retrospective case series. SETTING: Institutions where cardiologists performed atrial fibrillation ablation procedures. PATIENTS: 9 patients with atrial-esophageal fistulas after atrial fibrillation ablation. MEASUREMENTS: Demographic characteristics, mortality, presenting signs and symptoms, and days to presentation. RESULTS:Patients presented a mean of 12.3 days (range, 10 to 16 days) after their procedures. Nonspecific symptoms included fever, leukocytosis, and neurologic abnormalities. All patients died. Only 4 patients received correct diagnoses before death, although all patients presented to a physician. In 3 patients, surgical repair was attempted. LIMITATIONS: Few physicians reported cases, and only approximate numbers of procedures performed by the physicians are known. Thus, the authors could not estimate the incidence of atrial-esophageal fistulas after ablation. CONCLUSIONS: Formation of atrial-esophageal fistulas is a rare but potentially devastating complication of atrial fibrillation ablation. This disorder may have an indolent presentation and may mimic other disease states, such as stroke or sepsis.
Authors: Hugh Calkins; Gerhard Hindricks; Riccardo Cappato; Young-Hoon Kim; Eduardo B Saad; Luis Aguinaga; Joseph G Akar; Vinay Badhwar; Josep Brugada; John Camm; Peng-Sheng Chen; Shih-Ann Chen; Mina K Chung; Jens Cosedis Nielsen; Anne B Curtis; D Wyn Davies; John D Day; André d'Avila; N M S Natasja de Groot; Luigi Di Biase; Mattias Duytschaever; James R Edgerton; Kenneth A Ellenbogen; Patrick T Ellinor; Sabine Ernst; Guilherme Fenelon; Edward P Gerstenfeld; David E Haines; Michel Haissaguerre; Robert H Helm; Elaine Hylek; Warren M Jackman; Jose Jalife; Jonathan M Kalman; Josef Kautzner; Hans Kottkamp; Karl Heinz Kuck; Koichiro Kumagai; Richard Lee; Thorsten Lewalter; Bruce D Lindsay; Laurent Macle; Moussa Mansour; Francis E Marchlinski; Gregory F Michaud; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Ken Okumura; Douglas Packer; Evgeny Pokushalov; Matthew R Reynolds; Prashanthan Sanders; Mauricio Scanavacca; Richard Schilling; Claudio Tondo; Hsuan-Ming Tsao; Atul Verma; David J Wilber; Teiichi Yamane Journal: Heart Rhythm Date: 2017-05-12 Impact factor: 6.343
Authors: D N Stephens; J Cannata; Ruibin Liu; Jian Zhong Zhao; K K Shung; Hien Nguyen; R Chia; A Dentinger; D Wildes; K E Thomenius; A Mahajan; K Shivkumar; Kang Kim; M O'Donnell; A Nikoozadeh; O Oralkan; P T Khuri-Yakub; D J Sahn Journal: IEEE Trans Ultrason Ferroelectr Freq Control Date: 2008-07 Impact factor: 2.725