Eduardo Back Sternick1,2, Frederico Soares Correa1,2, Leonardo Ferber Drumond1,3, Rodrigo Albuquerque Carreiro1,4, Manuela Alves Rabelo1,5, Paulo de Tarso Vaz de Oliveira1,5. 1. Electrophysiology Unit, Biocor Instituto, Nova Lima, Minas Gerais, Brazil. 2. Department of Cardiovascular Surgery, Electrophysiology Unit, Biocor Instituto, Nova Lima, Minas Gerais, Brazil. 3. Department of Endoscopy and Cardiovascular Surgery, Biocor Instituto, Nova Lima, Minas Gerais, Brazil. 4. Department of Endoscopy, Biocor Instituto, Nova Lima, Minas Gerais, Brazil. 5. Department of Digestive Tract Surgery, Biocor Instituto, Nova Lima, Minas Gerais, Brazil.
Abstract
INTRODUCTION: Much have been reported about esophago-left atrium fistula. However, esophago-mediastinal fistula, not reaching the left atrium, has not been studied as a different clinical entity, with different management. METHODS AND RESULTS: We review and discuss the literature of esophago-mediastinum fistula after catheter ablation for atrial fibrillation with emphasis on the following points: the timing of its occurrence after ablation; the mechanisms and localization of the fistula; and its natural history. CONCLUSION: We showed that esophageal stenting was associated with a better outcome in patients with esophagus-mediastinal fistula, introduced the concept of left atrial wall weakening during ablation, and suggest a possible role of contact force use in fistula formation.
INTRODUCTION: Much have been reported about esophago-left atrium fistula. However, esophago-mediastinal fistula, not reaching the left atrium, has not been studied as a different clinical entity, with different management. METHODS AND RESULTS: We review and discuss the literature of esophago-mediastinum fistula after catheter ablation for atrial fibrillation with emphasis on the following points: the timing of its occurrence after ablation; the mechanisms and localization of the fistula; and its natural history. CONCLUSION: We showed that esophageal stenting was associated with a better outcome in patients with esophagus-mediastinal fistula, introduced the concept of left atrial wall weakening during ablation, and suggest a possible role of contact force use in fistula formation.