Physicians should consider atrial–esophageal fistula when evaluating patients who present with malaise, leukocytosis, or persistent fever after ablation procedures.
Cardiologists can cure patients with chronic atrial fibrillation by using radiofrequency ablation near the posterior wall of the left atrium. Although this procedure is considered to be safe and effective, the proximity of the left atrium to the esophagus does raise concerns about potential esophageal injury: Thermal effects generated within the lumen of the esophagus can lead to necrosis and subsequent atrial–esophageal fistulas.
In this retrospective case series, investigators reviewed data (provided anonymously by physicians) on nine patients who developed atrial–esophageal fistulas following radiofrequency catheter ablation. The ablations were performed by physicians with various levels of experience at centers with a wide range of case …