Survival of a Patient with an Esophagopericardial Fistula After Catheter Ablation for Atrial Fibrillation: A Case Report and Literature Review

Overview

Journal J Innov Card Rhythm Manag

Date 2020 May 29

PMID 32461814

Citations 1

Authors

Granit Veseli

Sei Iwai

Jason T Jacobson

Affiliations

Soon will be listed here.

Abstract

Esophageal injury leading to esophagopericardial fistula (EPF) or atrioesophageal fistula is a very rare and dreaded complication of catheter ablation for atrial fibrillation that carries a high mortality rate. We present a case of EPF following radiofrequency catheter ablation for atrial fibrillation and an extensive review of the literature regarding catheter ablation-related esophageal injury.

Citing Articles

Esophagopericardial Fistula and Pneumopericardium as a Complication of Pulmonary Vein Isolation in a 62-Year-Old Man with Atrial Fibrillation: A Case Report.

Udongwo N, Desai D, Kozlik A, Ilagan J, Chaughtai S, Zacks E Am J Case Rep. 2022; 23:e936315.

PMID: 35821628 PMC: 9288851. DOI: 10.12659/AJCR.936315.

References

Kapur S, Barbhaiya C, Deneke T, Michaud G . Esophageal Injury and Atrioesophageal Fistula Caused by Ablation for Atrial Fibrillation. Circulation. 2017; 136(13):1247-1255. DOI: 10.1161/CIRCULATIONAHA.117.025827. View

Gillinov A, Pettersson G, Rice T . Esophageal injury during radiofrequency ablation for atrial fibrillation. J Thorac Cardiovasc Surg. 2001; 122(6):1239-40. DOI: 10.1067/mtc.2001.118041. View

Borne R, Sauer W, Zipse M, Zheng L, Tzou W, Nguyen D . Longer Duration Versus Increasing Power During Radiofrequency Ablation Yields Different Ablation Lesion Characteristics. JACC Clin Electrophysiol. 2018; 4(7):902-908. DOI: 10.1016/j.jacep.2018.03.020. View

Halm U, Gaspar T, Zachaus M, Sack S, Arya A, Piorkowski C . Thermal esophageal lesions after radiofrequency catheter ablation of left atrial arrhythmias. Am J Gastroenterol. 2009; 105(3):551-6. DOI: 10.1038/ajg.2009.625. View

Bunch T, Nelson J, Foley T, Allison S, Crandall B, Osborn J . Temporary esophageal stenting allows healing of esophageal perforations following atrial fibrillation ablation procedures. J Cardiovasc Electrophysiol. 2006; 17(4):435-9. DOI: 10.1111/j.1540-8167.2006.00464.x. View

. Correction to: Atrial Fibrillation Thermographic and Endoscopic Monitoring of Patients: Safety Algorithm for the Esophagus: AF TEMP-SAFE Study. Circ Arrhythm Electrophysiol. 2019; 12(1):e000034. DOI: 10.1161/HAE.0000000000000034. View

Seo J, Park J, Jeong S . Pericardial-esophageal Fistula Complicating Atrial Fibrillation Ablation Successfully Resolved after Pericardial Drainage with Conservative Management. Korean Circ J. 2017; 47(6):970-977. PMC: 5711689. DOI: 10.4070/kcj.2016.0364. View

Leite L, Santos S, Maia H, Henz B, Giuseppin F, Oliverira A . Luminal esophageal temperature monitoring with a deflectable esophageal temperature probe and intracardiac echocardiography may reduce esophageal injury during atrial fibrillation ablation procedures: results of a pilot study. Circ Arrhythm Electrophysiol. 2011; 4(2):149-56. DOI: 10.1161/CIRCEP.110.960328. View

Pappone C, Oral H, Santinelli V, Vicedomini G, Lang C, Manguso F . Atrio-esophageal fistula as a complication of percutaneous transcatheter ablation of atrial fibrillation. Circulation. 2004; 109(22):2724-6. DOI: 10.1161/01.CIR.0000131866.44650.46. View

10.

Mateos J, Mateos E, Pena T, Lobo T, Pachon Mateos J, Vargas R . Simplified method for esophagus protection during radiofrequency catheter ablation of atrial fibrillation--prospective study of 704 cases. Rev Bras Cir Cardiovasc. 2015; 30(2):139-47. PMC: 4462958. DOI: 10.5935/1678-9741.20150009. View

11.

Barbhaiya C, Kumar S, John R, Tedrow U, Koplan B, Epstein L . Global survey of esophageal and gastric injury in atrial fibrillation ablation: incidence, time to presentation, and outcomes. J Am Coll Cardiol. 2015; 65(13):1377-1378. DOI: 10.1016/j.jacc.2014.12.053. View

12.

Leshem E, Zilberman I, Tschabrunn C, Barkagan M, Contreras-Valdes F, Govari A . High-Power and Short-Duration Ablation for Pulmonary Vein Isolation: Biophysical Characterization. JACC Clin Electrophysiol. 2018; 4(4):467-479. DOI: 10.1016/j.jacep.2017.11.018. View

13.

Ha F, Han H, Sanders P, Teh A, ODonnell D, Farouque O . Challenges and limitations in the diagnosis of atrioesophageal fistula. J Cardiovasc Electrophysiol. 2018; 29(6):861-871. DOI: 10.1111/jce.13494. View

14.

Nguyen D, Barham W, Zheng L, Dinegar S, Tzou W, Sauer W . Effect of radiofrequency energy delivery in proximity to metallic medical device components. Heart Rhythm. 2015; 12(10):2162-9. DOI: 10.1016/j.hrthm.2015.05.011. View

15.

Yarlagadda B, Deneke T, Turagam M, Dar T, Paleti S, Parikh V . Temporal relationships between esophageal injury type and progression in patients undergoing atrial fibrillation catheter ablation. Heart Rhythm. 2018; 16(2):204-212. DOI: 10.1016/j.hrthm.2018.09.027. View

16.

Vijayaraman P, Netrebko P, Geyfman V, Dandamudi G, Casey K, Ellenbogen K . Esophageal fistula formation despite esophageal monitoring and low-power radiofrequency catheter ablation for atrial fibrillation. Circ Arrhythm Electrophysiol. 2009; 2(5):e31-3. DOI: 10.1161/CIRCEP.109.883694. View

17.

Bhardwaj R, Naniwadekar A, Whang W, Mittnacht A, Palaniswamy C, Koruth J . Esophageal Deviation During Atrial Fibrillation Ablation: Clinical Experience With a Dedicated Esophageal Balloon Retractor. JACC Clin Electrophysiol. 2018; 4(8):1020-1030. DOI: 10.1016/j.jacep.2018.04.001. View

18.

Stockigt F, Schrickel J, Andrie R, Lickfett L . Atrioesophageal fistula after cryoballoon pulmonary vein isolation. J Cardiovasc Electrophysiol. 2012; 23(11):1254-7. DOI: 10.1111/j.1540-8167.2012.02324.x. View

19.

Hartman A, Glassman L, Katz S, Chinitz L, Ross W . Surgical repair of a left atrial-esophageal fistula after radiofrequency catheter ablation for atrial fibrillation. Ann Thorac Surg. 2012; 94(4):e91-3. DOI: 10.1016/j.athoracsur.2012.04.052. View

20.

Neven K, Schmidt B, Metzner A, Otomo K, Nuyens D, De Potter T . Fatal end of a safety algorithm for pulmonary vein isolation with use of high-intensity focused ultrasound. Circ Arrhythm Electrophysiol. 2010; 3(3):260-5. DOI: 10.1161/CIRCEP.109.922930. View