Ablating the Posterior Heart: Cardioesophageal Fistula Complicating Radiofrequency Ablation in the Coronary Sinus

Mahmut Fatih Güneş; Yalçin Gökoğlan; Luigi DI Biase; Carola Gianni; Sanghamitra Mohanty; Rodney Horton; Shane Bailey; Andrea Natale

doi:10.1111/jce.12831

Ablating the Posterior Heart: Cardioesophageal Fistula Complicating Radiofrequency Ablation in the Coronary Sinus

J Cardiovasc Electrophysiol. 2015 Dec;26(12):1376-8. doi: 10.1111/jce.12831. Epub 2015 Oct 12.

Authors

Mahmut Fatih Güneş¹, Yalçin Gökoğlan¹, Luigi DI Biase^{1

2

3

4}, Carola Gianni^{1

5}, Sanghamitra Mohanty¹, Rodney Horton^{1

3}, Shane Bailey¹, Andrea Natale^{1

2

3

6

7

8

9

10}

Affiliations

¹ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA.
² Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
³ Department of Biomedical Engineering, University of Texas, Austin, Texas, USA.
⁴ Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
⁵ Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
⁶ MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
⁷ Division of Cardiology, Stanford University School of Medicine, Stanford, California, USA.
⁸ Electrophysiology and Arrhythmia Services, California Pacific Medical Center, San Francisco, California, USA.
⁹ Interventional Electrophysiology, Scripps Clinic, La Jolla, California, USA.
¹⁰ Dell Medical School, University of Texas, Austin, Texas, USA.

PMID: 26456079
DOI: 10.1111/jce.12831

Abstract

Cardioesophageal fistulas (CEFs) are uncommon but life-threatening complications of radiofrequency (RF) catheter ablation of atrial fibrillation (AF). They are usually, but not exclusively, related to ablation of the left atrial posterior wall. We report a case of a 73-year-old man that presented with CEF following RF ablation in the coronary sinus, highlighting the importance of esophageal temperature monitoring whenever ablating in the posterior heart.

Keywords: atrial fibrillation; atrioesophageal fistula; catheter ablation; coronary sinus; esophagopericardial fistula.

Publication types

Case Reports

MeSH terms

Aged
Atrial Fibrillation / complications
Atrial Fibrillation / therapy
Body Temperature
Catheter Ablation / adverse effects
Catheter Ablation / methods*
Coronary Sinus
Esophageal Fistula / complications*
Esophageal Fistula / pathology
Fistula*
Heart Atria / pathology*
Heart Diseases / complications*
Heart Diseases / pathology
Humans
Male
Monitoring, Physiologic
Tomography, X-Ray Computed