Related Experiment Video
Updated: Jun 12, 2026
Cooling or Warming the Esophagus to Reduce Esophageal Injury During Left Atrial Ablation in the Treatment of Atrial Fibrillation
Published on: March 15, 2020
Atrial-esophageal fistula after atrial radiofrequency catheter ablation
Marc O Siegel1, David M Parenti, Gary L Simon
1Division of Infectious Diseases, George Washington University Medical Center, Washington, DC 20037, USA. msiegel@mfa.gwu.edu
Abstract:
Atrial-esophageal fistula is a rare but often fatal complication of catheter radiofrequency ablation. Patients occasionally have bacteremia and have been misdiagnosed with endocarditis. Infectious diseases specialists are often consulted and need to be aware of this complication. We report a case of atrial-esophageal fistula after radiofrequency ablation that illustrates the salient features of this illness.
Insights
Atrial-esophageal fistula is a rare, fatal complication after radiofrequency ablation. Early recognition is crucial for patients presenting with bacteremia, avoiding misdiagnosis of endocarditis.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Device Complications
Background:
- Catheter radiofrequency ablation is a common treatment for atrial arrhythmias.
- Atrial-esophageal fistula (AEF) is a rare but life-threatening complication.
- Patients may present with non-specific symptoms, including bacteremia.
Observation:
- A case of AEF following radiofrequency ablation is presented.
- The patient experienced bacteremia and was initially misdiagnosed with endocarditis.
- This highlights the diagnostic challenges associated with AEF.
Findings:
- AEF requires high clinical suspicion in patients with relevant history.
- Prompt diagnosis and management are critical for patient survival.
- Infectious diseases specialists must be aware of this potential complication.
Implications:
- Improved awareness and diagnostic criteria for AEF are needed.
- This case underscores the importance of considering AEF in the differential diagnosis.
- Enhanced vigilance can prevent delayed treatment and improve outcomes for patients undergoing ablation procedures.
