Why the study?
It is not known whether patients with existing esophageal disorders that dilate the esophagus are at higher risk of atrioesophageal fistula after pulmonary vein isolation.
Highlights the clinical consideration of atrioesophageal fistula risk when performing pulmonary vein isolation in patients with pre-existing esophageal dilation disorders like achalasia.
Atrioesophageal fistula (AEF) is a rare but life-threatening complication of catheter ablation of atrial fibrillation (AF), thought to occur in as many as 0.03%–0.08% of cases.1 It is not known if patients with existing esophageal disorders, particularly those that dilate the esophagus, are at higher risk of AEF after pulmonary vein isolation (PVI). Achalasia is an inflammatory and neurodegenerative disorder of the esophagus characterized by increased tone and failure of relaxation of the lower esophageal sphincter as well as absent peristalsis of the esophageal body, often leading to progressive esophageal dilation and megaesophagus.
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Dale et al. (2019) studied this question.
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