Key result
Radiofrequency catheter ablation for atrial fibrillation can rarely result in esophageal perforation and atrioesophageal fistula, requiring immediate surgical intervention.
Case Report (n=1)
Atrioesophageal fistula is a rare but severe complication of radiofrequency catheter ablation for atrial fibrillation that requires immediate surgical intervention and may be prevented by esophageal temperature monitoring and energy reduction.
Requires heightened post-ablation vigilance; case reports leave open optimal prevention strategies.
Radiofrequency catheter ablation of pulmonary veins is generally a safe procedure used in patients with atrial fibrillation. We report a case of a 67-year old woman who suffered esophageal perforation following radiofrequency catheter ablation. Salient symptoms, such as dysphagia, severe chest pain, palpitations, and malaise, as well as the radiological findings of pneumopericardium and esophageal perforation were consistent with the presence of an atrioesophageal fistula. This extremely rare complication warrants immediate surgical intervention. Atrio-esophageal fistula is best diagnosed by thoracic CT with contrast, and may be prevented during the procedure by careful esophageal temperature monitoring and reduction of radiofrequency energy.
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James X. Liu (2012) conducted a case report in Atrial fibrillation (n=1). Radiofrequency catheter ablation was evaluated on Esophageal perforation / atrioesophageal fistula. Radiofrequency catheter ablation for atrial fibrillation can rarely result in esophageal perforation and atrioesophageal fistula, requiring immediate surgical intervention.
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