Endoscopic Vacuum Therapy for the Treatment of Atrial Fibrillation Ablation-Induced Esophageal Perforation

Esophageal thermal injury from atrial fibrillation ablation is not uncommon; however, full-thickness perforation is rare. Such injuries are often treated with surgical revision, stent placement, or medical management. Endoscopic vacuum therapy is a novel and emerging technique to repair transmural gastrointestinal defects; however, its use in the management of esophageal thermal ulceration and perforation after a cardiac ablation procedure is limited. We present a 52-year-old man who developed a refractory esophageal perforation and leak secondary to atrial fibrillation radiofrequency ablation that was successfully treated with endoscopic vacuum therapy, demonstrating a minimally invasive endoscopic treatment modality when alternative therapies fail.