Download PDF
Thorac Cardiovasc Surg Rep 2013; 02(01): 013-015
DOI: 10.1055/s-0033-1358779
Cardiac Surgery
Georg Thieme Verlag KG Stuttgart · New York

Left Atrial-Esophageal Fistula Repair after Radiofrequency Catheter Ablation for Atrial Fibrillation

Jeffrey B. Velotta
1   Department of Thoracic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, United States
,
Charles R. Vasquez
2   Dana Farber Cancer Institute, Boston, Massachusetts, United States
,
Ralph M. Bolman
3   Department of Cardiac Surgery, Brigham and Women's Hospital, Boston, Massachusetts, United States
,
Marcelo C. Dasilva
1   Department of Thoracic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, United States
› Author Affiliations
Further Information

Publication History

30 May 2013

17 September 2013

Publication Date:
13 November 2013 (online)

Also available at
   Permissions and Reprints

Abstract

Left atrial-esophageal fistula (LAEF) is a rare complication of radiofrequency ablation (RFA) procedures undertaken for atrial fibrillation (AF). This complication is associated with significant morbidity and mortality. Currently, there is no clear consensus on the appropriate management strategy. We report a case of a LAEF that developed in a patient 2 weeks after RFA for medication refractory AF. The patient underwent successful repair of the fistula through a left posterolateral thoracotomy, wherein the esophageal and atrial lesions were repaired primarily with an intercostal muscle flap and bovine pericardial patch to reinforce and prevent recurrence.

Keywords

ablative therapy - atrial fibrillation - atrial-esophageal - esophageal surgery - thoracotomy
 

  • References

  • 1 Sonmez B, Demirsoy E, Yagan N , et al. A fatal complication due to radiofrequency ablation for atrial fibrillation: atrio-esophageal fistula. Ann Thorac Surg 2003; 76 (1) 281-283
    CrossrefPubMedGoogle Scholar
  • 2 Dagres N, Anastasiou-Nana M. Prevention of atrial-esophageal fistula after catheter ablation of atrial fibrillation. Curr Opin Cardiol 2011; 26 (1) 1-5
    CrossrefPubMedGoogle Scholar
  • 3 Stöllberger C, Pulgram T, Finsterer J. Neurological consequences of atrioesophageal fistula after radiofrequency ablation in atrial fibrillation. Arch Neurol 2009; 66 (7) 884-887
    CrossrefPubMedGoogle Scholar
  • 4 Siegel MO, Parenti DM, Simon GL. Atrial-esophageal fistula after atrial radiofrequency catheter ablation. Clin Infect Dis 2010; 51 (1) 73-76
    CrossrefPubMedGoogle Scholar
  • 5 Eitel C, Rolf S, Zachäus M , et al. Successful nonsurgical treatment of esophagopericardial fistulas after atrial fibrillation catheter ablation: a case series. Circ Arrhythm Electrophysiol 2013; 6 (4) 675-681
    CrossrefPubMedGoogle Scholar