Abstract
This study sought to assess the incidence, operator demographics, clinical characteristics, procedural factors, and prognosis of esophageal perforation and fistula after atrial fibrillation ablation. Esophageal injury is a feared complication of atrial fibrillation ablation. An Internet-based global survey soliciting anonymous information regarding esophageal perforation and fistula was emailed to 3,080 physicians. Detailed information regarding physician, patient, and procedural characteristics related to esophageal perforation with or without fistula was collected. The survey was completed by 405 of 3,080 physicians (13%). Responding physicians performed 191,215 atrial fibrillation ablations and esophageal perforation with or without fistula occurred in 31 patients (0.016%) with multiple ablation catheter types despite monitoring of esophageal position or temperature during ablation in 90% of patients. Among patients who present with esophageal perforation, death, or severe neurologic injury occurred more frequently in patients with greater body mass index (30.9 ± 6.8 kg/m2 vs. 25.8 ± 3.3 kg/m2; p = 0.03), and lower left ventricular ejection fraction (55.1 ± 9.1% vs. 61.7 ± 5.4%; p = 0.04). Among analyzed patients, atrial-eso...Continue Reading
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Apr 24, 2020·Journal of Cardiovascular Electrophysiology·Fabrizio R AssisHarikrishna Tandri
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