title: Management of Atrio-Esophageal Fistula Following Left Atrial Ablation.
abstract: Currently, no guidelines have been established for the treatment of atrio-esophageal fistula (AEF) secondary to left atrial ablation therapy. After comprehensive literature review, we aim to make suggestions on the management of this complex complication and also present a case series. We performed a review of the existing literature on AEF in the setting of atrial ablation. Using keywords atrial fibrillation, atrial ablation, fistula formation, atrio-esophageal fistula, complications, interventions, and prognosis, a search was made using the medical databases PUBMED and MEDLINE for reports in English from 2000 to April 2015. A statistical analysis was performed to compare the three different intervention arms: medical management, stent placement and surgical intervention. The results of our systematic review confirm the high mortality rate associated with AEF following left atrial ablation and the necessity to diagnose atrio-esophageal injury in a timely manner. The mortality rates of this complication are 96% with medical management alone, 100% with stent placement, and 33 % with surgical intervention. Atrio-esophageal injury and subsequent AEF is an infrequent but potentially fatal complication of atrial ablation. Early, prompt, and definitive surgical intervention is the treatment of choice.
authors.affiliation: Department of Internal Medicine, Advocate Christ Medical Center, 105 Covington Ct, Oak Brook, IL 60523, USA.
authors.forename: Tariq
authors.initials: T
authors.lastname: Yousuf
authors.affiliation: Department of Internal Medicine, Advocate Christ Medical Center, 105 Covington Ct, Oak Brook, IL 60523, USA.
authors.forename: Hesam
authors.initials: H
authors.lastname: Keshmiri
authors.affiliation: Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Bulwa
authors.affiliation: Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Kramer
authors.affiliation: Department of Internal Medicine, Advocate Christ Medical Center, 105 Covington Ct, Oak Brook, IL 60523, USA.
authors.forename: Hafiz Muhammad
authors.initials: HM
authors.lastname: Sharjeel Arshad
authors.affiliation: Department of Internal Medicine, Advocate Christ Medical Center, 105 Covington Ct, Oak Brook, IL 60523, USA.
authors.forename: Rasha
authors.initials: R
authors.lastname: Issa
authors.affiliation: Department of Internal Medicine, Advocate Christ Medical Center, 105 Covington Ct, Oak Brook, IL 60523, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Woznicka
authors.affiliation: Department of Cardiovascular Surgery, Advocate Christ Medical Center, Oak Lawn, IL, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Gordon
authors.affiliation: Department of Cardiology, Advocate Christ Medical Center, Oak Lawn, IL, USA.
authors.forename: Pierre
authors.initials: P
authors.lastname: Abi-Mansour
keywords: Arrhythmia; Atrial ablation; Atrial fibrillation; Atrio-esophageal fistula