AIMS: Rate, incidence, risk factors, and optimal management of atrio-oesophageal fistula (AOF) after catheter ablation for atrial fibrillation (AF) remain obscure. METHODS AND RESULTS: All French centres performing AF ablation were identified and surveys were sent concerning the number of procedures, eventual cases of AOF, and characteristics of such cases. Eighty-two of the 103 centres (80%) performing AF ablation in France were included, with a total of 129 286 AF ablations since 2006 (93% of the whole procedures in France). Thirty-three AOF were reported (reported rate 0.026% per procedure) with a stable reported annual incidence despite the increasing number of procedures. Sensitivity of computed tomography (CT) scan for AOF was 81%. Mortality was 60%, significantly lower in case of surgical corrective therapy (31 vs. 93%, P = 0.001). CONCLUSION: The reported rate of AOF after AF ablation in this nationwide survey was 0.026%, with a stable reported annual incidence over time. A normal CT scan does not rule out the diagnosis and should be repeated in case of suspicion. Prognosis remains poor with a mortality of 60% and crucially dependant of immediate surgical correction. No clear protective strategy has been proven effective. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Rate, incidence, risk factors, and optimal management of atrio-oesophageal fistula (AOF) after catheter ablation for atrial fibrillation (AF) remain obscure. METHODS AND RESULTS: All French centres performing AF ablation were identified and surveys were sent concerning the number of procedures, eventual cases of AOF, and characteristics of such cases. Eighty-two of the 103 centres (80%) performing AF ablation in France were included, with a total of 129 286 AF ablations since 2006 (93% of the whole procedures in France). Thirty-three AOF were reported (reported rate 0.026% per procedure) with a stable reported annual incidence despite the increasing number of procedures. Sensitivity of computed tomography (CT) scan for AOF was 81%. Mortality was 60%, significantly lower in case of surgical corrective therapy (31 vs. 93%, P = 0.001). CONCLUSION: The reported rate of AOF after AF ablation in this nationwide survey was 0.026%, with a stable reported annual incidence over time. A normal CT scan does not rule out the diagnosis and should be repeated in case of suspicion. Prognosis remains poor with a mortality of 60% and crucially dependant of immediate surgical correction. No clear protective strategy has been proven effective. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Rodrigue Garcia; Mathilde Clouard; Fabian Plank; Bruno Degand; Séverine Philibert; Gabriel Laurent; Pierre Poupin; Saliman Sakhy; Matthieu Gras; Markus Stühlinger; Nándor Szegedi; Szilvia Herczeg; Judit Simon; Harry J G M Crijns; Eloi Marijon; Luc Christiaens; Charles Guenancia Journal: Front Cardiovasc Med Date: 2022-09-26
Authors: Thomas Roxburgh; Anthony Li; Charles Guenancia; Patrice Pernollet; Claire Bouleti; Benjamin Alos; Matthieu Gras; Thomas Kerforne; Denis Frasca; François Le Gal; Luc Christiaens; Bruno Degand; Rodrigue Garcia Journal: J Med Internet Res Date: 2021-05-27 Impact factor: 5.428