PMID: 16618954Apr 19, 2006Paper

Brief communication: atrial-esophageal fistulas after radiofrequency ablation

Annals of Internal Medicine
Jennifer E CummingsAndrea Natale

Abstract

Ablation of atrial fibrillation is generally considered safe and effective. However, atrial-esophageal fistulas have recently been reported as a rare but fatal complication. To describe 9 patients with atrial-esophageal fistulas after ablation for atrial fibrillation. Retrospective case series. Institutions where cardiologists performed atrial fibrillation ablation procedures. 9 patients with atrial-esophageal fistulas after atrial fibrillation ablation. Demographic characteristics, mortality, presenting signs and symptoms, and days to presentation. 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. 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. Formation of atrial-esophageal fistulas is a rare but potentially devastating complication of atrial fibrillation ablation. This disorder may ha...Continue Reading

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