title: A delayed case of fatal atrioesophageal fistula following radiofrequency ablation for atrial fibrillation.
abstract: We describe the case of a 61-year-old man with a fatal atrioesophageal fistula following radiofrequency ablation (RFA) for paroxysmal atrial fibrillation (PAF). Esophageal injury was first noted on computed tomography (CT) scan 10 days following RFA. Fistulization occurred 41 days following the procedure. This is a delayed time course in comparison with published reports. The patient declined intervention and we have serial CT imaging documenting the natural progression from ulceration to fistula. Although the patient was on acid suppression, he received 2 courses of corticosteroids, which may have contributed to the progression of his esophageal ulcer.
authors.affiliation: Scripps Mercy Hospital, San Diego, California, USA. gwgilcrease@hotmail.com
authors.forename: Glynn W
authors.initials: GW
authors.lastname: Gilcrease
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Stein
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects*; D004562:Electrocardiography; D004937:Esophageal Fistula / Q000000981:diagnostic imaging / Q000209:etiology*; D017809:Fatal Outcome; D006325:Heart Atria; D006335:Heart Injuries / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed
chemical_list: D000305:Adrenal Cortex Hormones