Early diagnosis and treatment with a fully covered esophageal stent may successfully prevent fatal atrioesophageal fistula formation following esophageal perforation during AF ablation.
May support covered stenting to avert fistula after esophageal perforation in AF ablation; leaves open need for prospective validation.
Atrioesophageal fistula (AEF) is an uncommon, underreported, and typically fatal complication of left atrial (LA) catheter ablation for atrial fibrillation (AF). The prevalence of AEF in the literature has been reported as 0.03%, and is highly dependent upon physician reporting. AEF is associated with a mortality rate of over 80% and major cerebrovascular morbidity from septic thrombi and embolic stroke. We present a case of esophageal perforation following persistent AF catheter ablation, with successful avoidance of AE fistula formation, as a result of early diagnosis and treatment, including endoscopic evaluation of the covered stent 2 weeks following insertion.
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Ellis et al. (2012) studied this question.
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