The Fatal Link Atrial Esophageal Fistula after Atrial Fibrillation Catheter Ablation

Case Report

Volume 01, Issue 01 (April–June 2025)

The Fatal Link: Atrial-Esophageal Fistula after Atrial Fibrillation Catheter Ablation

Aamer Ubaid¹, Erasmus Mutabi^2*, Yasser Sammour³, Seba Hasan⁴ and Robert Tanenbaum⁵

¹Department of Cardiovascular Medicine, Allegheny General Hospital, Pittsburgh, PA, USA
²Department of Medicine, Allegheny General Hospital, Pittsburgh, PA, USA
³Department of Cardiology, Houston Methodist Hospital, Houston, TX, USA
⁴Department of Internal Medicine, Division of Pulmonary-Critical Care & Sleep Medicine, SSM Health Saint Louis University Hospital, St Louis, MO, USA
⁵Department of Cardiovascular Medicine, Mid America Heart Institute, Kansas City, MO, USA

^*Corresponding author: Dr. Erasmus Mutabi, Department of Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA.
E-mail: emutabi@gmail.com.

DOI: doi.org/10.64874/crcscj.v1i1.2025.004

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Abstract

Catheter ablation, a cornerstone in the management of symptomatic atrial fibrillation (AF), has been shown to be successful in rhythm control in most patients. It is, however, not without the risk of serious complications, including atrial-esophageal fistula (AEF). This article reports the case of a 64-year-old man whose AF catheter ablation course was complicated by AEF, leading to a fatal outcome. This unfortunate outcome serves to highlight the importance of early diagnosis and treatment of AEF. Clinicians should also be cognizant of AEF risk factors. They should be capable of recognizing the clinical presentation of AEF signs and symptoms so that diagnosis and treatment can be made in a timely manner. After diagnosis, surgery is the preferred treatment, which has been shown to improve outcomes and reduce mortality.

Keywords: Atrio-esophageal fistula; Catheter ablation; Atrial fibrillation; Hemodynamic instability

Article Details

The Fatal Link: Atrial-Esophageal Fistula after Atrial Fibrillation Catheter Ablation