Why the study?
Esophago-mediastinal fistula not reaching the left atrium had not been studied as a distinct clinical entity with different management compared to esophago-left atrium fistula.
Does esophageal stenting improve outcomes in patients with esophago-mediastinal fistula after catheter ablation for atrial fibrillation?
Does esophageal stenting improve outcomes in patients with esophago-mediastinal fistula after catheter ablation for atrial fibrillation?
Esophageal stenting is associated with better outcomes in patients developing esophago-mediastinal fistula after atrial fibrillation ablation.
Esophago-mediastinal fistula merits recognition as a distinct entity from atrio-esophageal fistula; leaves open evidence-based management strategies.
INTRODUCTION: Much have been reported about esophago-left atrium fistula. However, esophago-mediastinal fistula, not reaching the left atrium, has not been studied as a different clinical entity, with different management. METHODS AND RESULTS: We review and discuss the literature of esophago-mediastinum fistula after catheter ablation for atrial fibrillation with emphasis on the following points: the timing of its occurrence after ablation; the mechanisms and localization of the fistula; and its natural history. CONCLUSION: We showed that esophageal stenting was associated with a better outcome in patients with esophagus-mediastinal fistula, introduced the concept of left atrial wall weakening during ablation, and suggest a possible role of contact force use in fistula formation.
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Sternick et al. (2020) studied this question.
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