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A Simple Way to Exclude a Lethal Complication Following Atrial Fibrillation Radiofrequency Ablation: A Case Report.
Pacing Clin Electrophysiol
January 2025
Department of Cardiology, University Hospital of Patras, Rion-Patras, Greece.
Esophageal injury is a serious complication following atrial fibrillation catheter ablation procedures. It may manifest as atrio-esophageal fistula, pericardio-esophageal fistula (PEF), or restricted perforation, with high mortality rate if left unoperated. Chest computed tomography with intravenous contrast is the mainstay of diagnosis; however, a definite imaging diagnosis is often delayed and may worsen patient outcomes.
View Article and Find Full Text PDFPulsed-field ablation does not induce esophageal and periesophageal injury-A new esophageal safety paradigm in catheter ablation of atrial fibrillation.
J Cardiovasc Electrophysiol
January 2024
Arrhythmia Section, Division of Cardiology, Zentralklinik Bad Berka, Bad Berka, Germany.
Introduction: Esophageal injury is one of the most serious complications of pulmonary vein isolation (PVI) with thermic energy sources. Better tissue selectivity of primarily non-thermic pulsed field ablation (PFA) may eliminate collateral injury, particularly the risk of atrio-esophageal fistula (AEF).
Objective: To compare the incidence of any (peri)-esophageal injury following PVI using PFA to thermic energy sources.
Esophageal Protection and Temperature Monitoring Using the Circa S-Cath™ Temperature Probe during Epicardial Radiofrequency Ablation of the Pulmonary Veins and Posterior Left Atrium.
J Clin Med
November 2022
Department of Cardiac Surgery, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium.
Although epicardial bipolar radiofrequency ablation should diminish the risk of esophageal thermal injury in comparison to an endocardial ablation, cases of lethal atrio-esophageal fistula have been reported. To better understand this risk and to reduce the possibility of a thermal injury, we monitored the esophageal temperature with the Circa S-Cath™ temperature probe during and immediately after the ablation while implementing three procedural safety measures. Twenty patients (15 males; 63 ± 10 years) were prospectively enrolled (November 2019-February 2021).
View Article and Find Full Text PDFAcquired atrioesophageal fistula: Need it be lethal? Sizing up the problem, diagnostic modalities, and best management.
J Card Surg
December 2022
Department of Cardio-Thoracic Surgery, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.
Background And Aim Of The Study: An atrioesophageal fistula is a devastating complication of ablation for atrial fibrillation. For the surgeon facing this dreaded complication, it may be a 'once in a lifetime' case. This review aims to describe the clinical problem and evaluate the outcome of different surgical techniques to start guiding cardiothoracic surgeons toward those which offer the best chance of survival.
View Article and Find Full Text PDFEsophageal Findings in the Setting of a Novel Preventive Strategy to Avoid Thermal Lesions during Hybrid Thoracoscopic Radiofrequency Ablation for Atrial Fibrillation.
J Clin Med
October 2021
Cardiac Surgery Department, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium.
Purpose The development of an atrio-esophageal fistula, a rare yet potentially lethal complication of ablation for atrial fibrillation, could be related to direct tissue heat transfer during and immediately after the ablation. We therefore studied the postoperative esophageal findings by esophagogastroduodenoscopy in patients that underwent a hybrid ablation procedure using a novel preventive strategy to avoid thermal lesions. Methods Thirty-four patients (28 males; 65 years ± 9 years) were retrospectively included.
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