Atrial-oesophageal fistula following percutaneous radiofrequency catheter ablation of atrial fibrillation: the risk still persists.

Aims: Atrial-oesophageal fistula is a serious complication related to ablation of atrial fibrillation. As its occurrence is rare, there is a great lack of information about their mechanisms, incidence, presentations, and treatment. The objective of this manuscript is to present a series of cases of atrial-oesophageal fistula in Brazil, focusing on incidence, clinical presentation, and follow-up.

Surgical treatment of atrial fibrillation through isolation of the left atrial posterior wall in patients with chronic rheumatic mitral valve disease. A randomized study with control group.

Objective: To determine the effectiveness of surgical isolation of the left atrial posterior wall encompassing the ostia of the pulmonary veins for the treatment of atrial fibrillation of rheumatic etiology.

Methods: Prospective and randomized study of patients with rheumatic mitral valve disease, persistent atrial fibrillation for 6 months or longer, age < or = 60 years, and left atrial diameter < or = 65 mm. The patients were randomly distributed into 2 groups as follows: surgical valvular treatment (control group) and surgical valvular treatment associated with isolation of the left atrial posterior wall according to the "cut-and-sew" technique (treated group).

Block of the mitral-pulmonary isthmus during ablation of a single left-sided accessory pathway causing different patterns of retrograde atrial activation.

The case of a 16-year-old patient with atrioventricular tachycardia caused by a single left anterolateral accessory pathway is reported. When the patient underwent radiofrequency ablation, a lesion on the mitral annulus lateral wall produced changes in the retrograde atrial activation pattern determined by that pathway; changes ranged from a delay in depolarization of the annulus posterior portions to full left atrium counterclockwise activation. Such phenomena were probably caused by a block in the isthmus between the annulus and the lower left pulmonary vein ostium.