Abstract
Atrial fibrillation (AF) affects 4% of individuals over 60 years old, an incidence rising to 9% in those over 80. For patients with symptomatic AF unresponsive to medication, catheter ablation is a common treatment, though it carries risks including cardiac tamponade, thromboembolic events, and rarely, atrio-esophageal fistula (AEF). AEF, a severe complication (up to 0.1%) with a mortality rate of 67%-100%, arises from thermal injury to the esophagus. Cardiac, neurologic or infection related symptoms appear 2 days to 6 weeks post-procedure. This report details a case of a patient who developed AEF following AF ablation. Initial symptoms included chest pain and nausea, which progressed to severe neurological deficits and septic shock. Diagnosis was confirmed by imaging, and the patient underwent urgent surgery to repair the fistula. Despite intensive care and surgical intervention, the patient faced significant complications, highlighting the critical need for early detection and prompt management of AEF.
Keywords
Atrio-esophageal fistula (AEF), Atrial fibrillation ablation, Radiofrequency ablation, Postablation complications, Left atrium, Esophageal perforation, Cardiac complications, Diagnosis and imaging in AEF