Management of Atrio-Esophageal Fistula Following Left Atrial Ablation
Open Access
- 1 January 2016
- journal article
- Published by Elmer Press, Inc. in Cardiology Research
- Vol. 7 (1), 36-45
- https://doi.org/10.14740/cr454e
Abstract
Currently, no guidelines have been established for the treatment of atrio-esophageal fistula (AEF) secondary to left atrial ablation therapy. After comprehensive literature review, we aim to make suggestions on the management of this complex complication and also present a case series. We performed a review of the existing literature on AEF in the setting of atrial ablation. Using keywords atrial fibrillation, atrial ablation, fistula formation, atrio-esophageal fistula, complications, interventions, and prognosis, a search was made using the medical databases PUBMED and MEDLINE for reports in English from 2000 to April 2015. A statistical analysis was performed to compare the three different intervention arms: medical management, stent placement and surgical intervention. The results of our systematic review confirm the high mortality rate associated with AEF following left atrial ablation and the necessity to diagnose atrio-esophageal injury in a timely manner. The mortality rates of this complication are 96% with medical management alone, 100% with stent placement, and 33 % with surgical intervention. Atrio-esophageal injury and subsequent AEF is an infrequent but potentially fatal complication of atrial ablation. Early, prompt, and definitive surgical intervention is the treatment of choice.Keywords
This publication has 51 references indexed in Scilit:
- A fatal case of atrioesophageal fistula following radiofrequency ablation of left atrium and pulmonary veins for atrial fibrillationCardiovascular Pathology, 2014
- Successful non-operative management of left atrioesophageal fistula following catheter ablationSurgery Today, 2013
- Successful Nonsurgical Treatment of Esophagopericardial Fistulas After Atrial Fibrillation Catheter AblationCirculation: Arrhythmia and Electrophysiology, 2013
- Complications of atrial fibrillation ablation: when prevention is better than cureEP Europace, 2011
- Successful surgery for atrioesophageal fistula caused by transcatheter ablation of atrial fibrillationThe Journal of Thoracic and Cardiovascular Surgery, 2010
- Atrial‐Esophageal Fistula after Atrial Radiofrequency Catheter AblationClinical Infectious Diseases, 2010
- Neurological Consequences of Atrioesophageal Fistula After Radiofrequency Ablation in Atrial FibrillationArchives of Neurology, 2009
- CT Radiographic FindingsJournal of Thoracic Imaging, 2007
- Left Atrial–Esophageal Fistula Following Radiofrequency Catheter Ablation of Atrial FibrillationJournal of Cardiovascular Electrophysiology, 2004
- Esophageal perforation during left atrial radiofrequency ablation: Is the risk too high?The Journal of Thoracic and Cardiovascular Surgery, 2003