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Updated: Jan 31, 2026

Robotic Ablation of Atrial Fibrillation
Published on: May 29, 2015
Suspected Atrioesophageal Fistula After Atrial Fibrillation Ablation: A Conservative Approach
Kaveen Sivakumaran1, Liyad Ahmed1, Alfredo Pantano1
1Division of Electrophysiology, Department of Cardiac Health, Southlake Health, Newmarket, Ontario, Canada.
Case Summary:
Blood cultures yielded Streptococcus salivarius/anginosus. Broad-spectrum antibiotics were initiated and later escalated to include gram-positive bacteria and anaerobic bacterial coverage for presumed polymicrobial infection. The patient was kept nothing by mouth and started on total parenteral nutrition. Computed tomography found an outpouching of the posterior left atrial wall, raising concern for AEF. Repeat computed tomography demonstrated no abnormality, and serial blood cultures remained sterile. The patient exhibited nearly full clinical recovery after 6 weeks of antibiotic therapy.
Discussion:
Diagnosis and treatment of AEF remains a significant clinical challenge. This case highlights conservative management of suspected AEF through antibiotic therapy and diet modification.
Take-Home Message:
Conservative treatment of suspected AEF may be possible with early recognition of symptomatic presentation.
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