Radiofrequency-induced esophageal injury: A thin barrier of protection

Electrophysiologists must sort through many options in order to manage the risk of lethal "collateral damage" to the esophagus and the development of atrioesophageal fistulas during ablation of atrial fibrillation (AF). Although the risk is low (≈0.03%–0.1%), 1 Ghia K.K. Chugh A. Good E. et al. A nationwide survey on the prevalence of atrioesophageal fistula after left atrial radiofrequency catheter ablation. J Inter Card Electrophysiol. 2009; 24: 33-36 Crossref PubMed Scopus (166) Google Scholar , 2 Pappone C. Oral H. Santinelli V. et al. Atrio-esophageal fistula as a complication of percutaneous transcatheter ablation of atrial fibrillation. Circulation. 2004; 109: 2724-2726 Crossref PubMed Scopus (769) Google Scholar the high mortality mandates that electrophysiologists use a protocol that protects the esophagus. Identification of a high-risk population for esophageal injury during radiofrequency catheter ablation of atrial fibrillation: Procedural and anatomical considerationsHeart RhythmVol. 7Issue 9PreviewAtrioesophageal fistula is an uncommon but life-threatening complication of atrial fibrillation (AF) ablation. Esophageal ulcerations (ESUL) have been proposed to be potential precursor lesions. Full-Text PDF