Case reportSuccessful Repair of an Atrioesophageal Fistula After Catheter Ablation for Atrial Fibrillation
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Comment
We report a case of successful repair of an AEF after RFA for AF. RFA of the atrial wall is an increasingly common treatment for arrhythmias [5]. Although a generally safe procedure, the increasing frequency has revealed some rare but devastating complications. While uncommon, thermal injury to the esophagus is possible secondary to the proximity of the posterior LA wall to the esophagus [4], the thin atrial wall [4], and the absence of pericardium in this area [6]. Mild thermal injury to the
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Cited by (17)
Atrioesophageal fistula from percutaneous ablation for atrial fibrillation
2021, JTCVS TechniquesNovel Approach for Repair of a Left Atrial Esophageal Fistula After Radiofrequency Ablation
2021, Annals of Thoracic SurgeryCitation Excerpt :An ideal approach for LAEF repair should not only provide excellent exposure in need of full debridement and both left atrial posterior wall and esophageal repairs but also effectively prevent ongoing embolic injury and massive gastrointestinal bleeding before complete repair is achieved.2 Although several surgical approaches including esophageal stent placement, cervical esophageal ligation with decompression, transthoracic extracardiac repair with or without CPB, and direct intracardiac repair have been reported, the optimal repair approach is not established.3,4 There was only 1 case report of a successful esophageal stenting, but most reports demonstrated the danger of esophageal instrumentation in the presence of a LAEF.
Transplantation of Lungs Procured From a Donor With an Atrioesophageal Fistula
2019, Annals of Thoracic SurgeryOptimal Approach for Repair of Left Atrial-Esophageal Fistula Complicating Radiofrequency Ablation
2018, Annals of Thoracic SurgeryCitation Excerpt :A few reports in the literature have described surgical management of this complication. Surgical techniques include esophageal stent placement, cervical esophageal ligation with decompression, and primary surgical repair through a sternotomy or thoracotomy, with or without the use of CPB [3–7]. The optimal approach and technique for repair is unknown.
CASE 9 - 2015 Anesthetic Management of a Patient with Esophago-Pericardial Fistula Complicating Atrial Fibrillation Radiofrequency Ablation
2015, Journal of Cardiothoracic and Vascular AnesthesiaCitation Excerpt :Because most patients are asymptomatic, esophageal prophylaxis with H2 receptor blockers, sucralfate, and proton pump inhibitors (PPIs) after CA usually are initiated.11,13 The keys to successful management of EPF or LAEF are early diagnosis and surgical repair to prevent fatal complications, such as septic shock, cardiogenic shock, embolic stroke, and death.8,9,14 Physicians should have a high index of suspicion and order the appropriate tests whenever a patient presents after AF ablation with the aforementioned symptoms.
Hyperbaric oxygen therapy for treatment of neurologic sequela after atrioesophageal fistula
2015, Annals of Thoracic SurgeryCitation Excerpt :Second, the patient underwent successful primary surgical repair of both the atrium and the esophagus without the need for CPB. Previous reports of successful AEF repair have included the use of CPB [5, 6]. Although CPB may be necessary in the event of large atrial defects, the atrial aspect of the fistula in this instance was able to be isolated and controlled without CPB.