ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2025
Surveillance of esophageal injury after atrial fibrillation catheter ablation.
Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Early-Stage Esophago-Mediastinal Fistula After Atrial Fibrillation Radiofrequency Ablation Successfully Treated With Endoscopic Vacuum Therapy.Journal of cardiovascular electrophysiology · 2026Article
- A predictive model for esophageal thermal injury following atrial fibrillation ablation : Risk tool for esophageal thermal injury.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Brazilian Atrial Fibrillation Guidelines - 2025.Arquivos brasileiros de cardiologia · 2025Article
- Minimizing Atrioesophageal Fistula Risk After AF Ablation: Risk Factors, Prevention, and Emerging Mini-Thermal Technology.Pacing and clinical electrophysiology : PACE · 2025Review
- Severe Esophageal Complications Following Atrial Fibrillation Ablation: Should We Still Be Concerned?Arquivos brasileiros de cardiologia · 2025Review
- Esophageal Protection Strategies for Ablation of Atrial Fibrillation: Comparative Results of Consecutive Endoscopic Evaluation.Arquivos brasileiros de cardiologia · 2025Article
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Authors and funding
10 authors.
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Abstract
aimsAtrial-esophageal fistula following ablation procedures for atrial fibrillation (AF) remains a major concern. There is no standardized approach to minimize the risk and morbidity of this serious complication. The objective of this study was to present the 7-year experience of systematic endoscopic surveillance of esophageal injury after AF catheter ablation.
methodsThis was a retrospective single-center registry of systematic endoscopic evaluations after consecutive AF ablation procedures performed from 2016 to 2022.
resultsA total of 677 AF ablation procedures with controlled esophagogastroduodenoscopy (EGD) were analyzed during that period. Most patients were male (71%) with paroxysmal AF (71%). Radiofrequency with electroanatomical mapping was the main ablation approach for 633 patients (93.5%). Esophageal temperature monitoring was performed using a single sensor in 220 patients (34.3%) and a multisensor probe in 296 patients (46%). Most of the patients presented no esophageal lesions (75,7%). Severe lesions (Kansas-city-classification KCC 2B) were found in 46 (6.8%) of them, requiring a new EGD in 7 days. KCC2B lesions were persistent in 3 patients, 2 of whom had ulcers during healing and 1 patient with a deep ulcer of 10 mm who was admitted to the hospital and underwent fasting and parenteral nutrition. The ulcer healed in the second week after the procedure. Both esophageal temperature monitoring strategies were equivalent at preventing thermal lesions. Additionally, a greater left atrium (LA) was associated with a lower incidence of esophageal ulcer (P = 0.028). Most of the lesions spontaneously healed.
conclusionThe incidence of esophageal injury after ablation was 24.3%. Most (72%) were mild lesions that required no therapeutic intervention. A larger left atrium (LA) was correlated with a lower incidence of thermal lesions. Early endoscopy can help diagnose severe esophageal lesions and may provide additional information for the surveillance of esophageal injury after AF ablation.
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