ArticleBMC surgery2025
Atrioesophageal fistula after atrial fibrillation ablation: a single-center experience with multicenter comparisons.
Article in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Establishment of a feasible surgical strategy for aortoesophageal fistula.JTCVS techniques · 2026Article
- Safety and Efficacy of Nighttime Versus Daytime Radiofrequency Catheter Ablation for Atrial Fibrillation: A Multicenter Cohort Study.Journal of cardiovascular electrophysiology · 2026Article
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Authors and funding
6 authors.
Funding
Abstract
backgroundAtrioesophageal fistula (AEF) is a rare yet highly lethal complication after radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF). Efficient screening and prompt surgical intervention within a multidisciplinary framework are critical for improving survival.
methodsWe retrospectively analyzed 12 patients who developed AEF after RFCA and underwent surgical repair at Beijing Anzhen Hospital from 2020 to 2024. A rapid screening protocol was implemented, including symptom-triggered CT/CTA with 48-h repeat imaging if needed and immediate surgical treatment under multidisciplinary team (MDT) consultation. Surgical management included median sternotomy under cardiopulmonary bypass (CPB) plus left thoracotomy, with atrial and esophageal repair and omental interposition.
resultsThe mean age was 63.5 ± 6.4 years, with 9 males and 3 females. Symptom onset occurred at a mean of 12.4 ± 8.1 days after ablation, most commonly fever (91.7%) and chest pain (83.3%). Diagnosis was achieved within 2 (range 1-10) days. All patients underwent emergency surgery; 11 received one-stage repair, while one required esophageal diversion due to severe mediastinitis. The in-hospital survival rate was 91.7% (11/12), with no recurrence observed during a median follow-up 12 (range 3-18) months. Postoperative complications occurred in two patients (16.7%), both developing pneumonia which resolved with antibiotic therapy.
conclusionA structured rapid screening pathway combined with prompt MDT-based surgical treatment significantly improved survival in patients with AEF. Our protocol achieved a high survival rate and may offer a valuable reference for other centers.
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