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Atrioesophageal fistula post atrial fibrillation ablation: A multicenter study from China
Author(s) -
Li ChangYi,
Li SongNan,
Jiang ChenYang,
Fu Hua,
Liang Ming,
Wang ZuLu,
Zhong JingQuan,
Zhou XianHui,
Wu Qi,
Chang Dong,
Wang Yan,
Zhou GenQing,
Liu WenShao,
Song Wei,
Sang CaiHua,
Long DeYong,
Du Xin,
Dong JianZeng,
Ma ChangSheng
Publication year - 2020
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.13973
Subject(s) - medicine , atrial fibrillation , ablation , epidemiology , complication , catheter ablation , fistula , surgery
Background and objective Atrioesophageal fistula (AEF) is a rare but devastating complication with high mortality post atrial fibrillation (AF) ablation. The purpose of current study was to determine the epidemiology, clinical features, pathogenesis, and management of AEF after AF ablation. Methods and results Patients with diagnosed AEF were included and retrospectively analyzed according to the registry of 11 centers in China from January 2010 to December 2019. A total of 16 AEF cases were identified from 44 794 patients who received a left atrial ablation procedure (0.035% per procedure). The interval from procedure to clinical onset of AEF averaged 18.3 days (3‐39 days). The fever ranked the most common symptom, occurred in 14 of the 16 cases, followed by neurological deficits (n = 11), chest pain (n = 5), and hematemesis (n = 4). Patients undergoing surgical repair had a better prognosis compared to those receiving nonsurgical management ([4 of 8] 50.0% vs [8 of 8] 100%, P < .05) with an overall mortality rate of 75.0%. Conclusion AEF is highly characterized by varied manifestations. Early diagnosis and urgent surgical repair are vital to those patients and associated with improved survival rates.