Article
Medicine, General & Internal
Fan He, Wei-Min Zhang, Bi-Jun Xu, Gang-Ping Huang, Huai-Dong Chen
Summary: Atrioesophageal fistula (AEF) is a rare but fatal complication after catheter ablation, requiring early vigilance, recognition, and surgical treatment.
Article
Cardiac & Cardiovascular Systems
Gaigai Ma, Xinhong Wang, Zhenhua Han, Chaoying Zhang, Qiangsun Zheng
Summary: A case of paroxysmal atrial fibrillation (AF) with atrioesophageal fistula (AEF) after combined therapy of catheter ablation and percutaneous left atrial appendage closure (LAAC) was successfully treated without major surgery or esophageal stenting. Early detection, rapid treatment, and constant awareness of potential fatal consequences are essential for successful management of AEF.
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY
(2023)
Article
Medicine, General & Internal
Oussama M. Wazni, Gopi Dandamudi, Nitesh Sood, Robert Hoyt, Jaret Tyler, Sarfraz Durrani, Mark Niebauer, Kevin Makati, Blair Halperin, Andre Gauri, Gustavo Morales, Mingyuan Shao, Jeffrey Cerkvenik, Rachelle E. Kaplon, Steven E. Nissen
Summary: In this multicenter trial, cryoballoon ablation as initial therapy was found to be superior to drug therapy in preventing atrial arrhythmia recurrence in patients with paroxysmal atrial fibrillation. Serious procedure-related adverse events were uncommon.
NEW ENGLAND JOURNAL OF MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Roland Richard Tilz, Vanessa Schmidt, Helmut Puererfellner, Philippe Maury, K. R. Julian Chun, Martin Martinek, Christian Sohns, Boris Schmidt, Franck Mandel, Estelle Gandjbakhch, Mikael Laredo, Melanie Anuscha Gunawardene, Stephan Willems, Thomas Beiert, Martin Borlich, Leon Iden, Anna Fueting, Raphael Spittler, Thomas Gaspar, Sergio Richter, Anja Schade, Malte Kuniss, Thomas Neumann, Alexander Francke, Carsten Wunderlich, Dong-In Shin, Dirk Grosse Meininghaus, Mike Foresti, Marc Bonsels, David Reek, Uwe Wiegand, Alexander Bauer, Andreas Metzner, Lars Eckardt, Sorin Tefan Popescu, Olaf Krahnefeld, Christian Sticherling, Michael Kuehne, Dinh Quang Nguyen, Laurent Roten, Ardan M. Saguner, Dominik Linz, Pepijn van der Voort, Bart A. Mulder, Johan Vijgen, Alexandre Almorad, Charles Guenancia, Laurent Fauchier, Serge Boveda, Y. De Greef, Antoine Da Costa, Pierre Jais, Nicolas Derval, Antoine Milhem, Laurence Jesel, Rodrigue Garcia, Herve Poty, Ziad Khoueiry, Julien Seitz, Julien Laborderie, Alexis Mechulan, Francois Brigadeau, Alexandre Zhao, Yannick Saludas, Olivier Piot, Nikhil Ahluwalia, Claire Martin, Jian Chen, Bor Antolic, Georgios Leventopoulos, Emin Evren Ozcan, Hikmet Yorgun, Serkan Cay, Kivanc Yalin, Maichel Sobhy Botros, Ahmed Taher Mahmoud, Ewa Jedrzejczyk-Patej, Osamu Inaba, Ken Okumura, Koichiro Ejima, Houman Khakpour, Noel Boyle, John N. Catanzaro, Vivek Reddy, Sanghamitra Mohanty, Andrea Natale, Hermann Blessberger, Bing Yang, Irene Stevens, Philipp Sommer, Christian Veltmann, Daniel Steven, Julia Vogler, Karl-Heinz Kuck, Jose Luis Merino, Ahmad Keelani, Christian-H. Heeger
Summary: This international multicentre registry investigates the characteristics of oesophageal fistulae after treatment of atrial fibrillation by catheter ablation. The incidence of oesophageal fistula is low and mainly associated with the use of radiofrequency energy. Mortality rate is exceedingly high without surgical or endoscopic intervention.
EUROPEAN HEART JOURNAL
(2023)
Article
Biology
Alexey Evtushenko, Vladimir Evtushenko, Anna Gusakova, Tatiana Suslova, Yulia Varlamova, Konstantin Zavadovskiy, Denis Lebedev, Anton Kutikhin, Elena Pavlyukova, Sergey Mamchur
Summary: We investigated the effects of radiofrequency ablation (RFA) on neurohumoral transmitter levels and myocardial I-123-metaiodobenzylguanidine (I-123-MIBG) uptake in patients with acquired valvular heart disease. The decrease in norepinephrine (NE) level in the coronary sinus was directly associated with the heart-to-mediastinum ratio and negatively correlated with I-123-MIBG uptake defects. NE level decreased significantly after surgery in both atrial fibrillation (AF) patients and patients with sinus rhythm. The difference in NE levels between the ascending aorta and coronary sinus (& UDelta;NE) of -400 pg/mL was determined as a cut-off value to evaluate RFA efficacy.
Article
Cardiac & Cardiovascular Systems
Qussay Marashly, Chaitra Gopinath, Alex Baher, Madan Acharya, Mobin Kheirkhahan, Benjamin Hardisty, Mossab Aljuaid, Ibrahim Tawhari, Mark Ibrahim, Alan K. Morris, Eugene G. Kholmovski, Brent D. Wilson, Nassir F. Marrouche, Mihail G. Chelu
Summary: LGE-MRI is useful for detecting and characterizing ETI across the entire severity spectrum, exhibiting extremely high sensitivity and negative predictive value in screening for ETI after AF ablation.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2021)
Editorial Material
Cardiac & Cardiovascular Systems
Rani Kronenberger, Fazia Mana, Gian-Battista Chierchia, Mark La Meir
Summary: Atrioesophageal fistula, a rare complication of atrial ablation, has a high mortality rate without established treatment guidelines. Successful surgical management can avoid the need for esophageal surgery, and a novel approach combining different techniques may offer a more favorable prognosis.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2022)
Letter
Medicine, General & Internal
Isaac W. Leon-acuna, Takeki Suzuki
Summary: Andrade et al. found that initial catheter cryoballoon ablation strategy resulted in lower incidence of persistent atrial fibrillation and lower arrhythmia burden compared to antiarrhythmic drug therapy in patients with paroxysmal atrial fibrillation during 3 years of follow-up. The study builds upon the findings of the EARLY-AF trial and the STOP AF First trial. Due to the relatively small sample size (303 patients) and short follow-up period, it may be difficult to detect mortality benefits of cryoballoon ablation.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Medicine, General & Internal
Yun Young Choi, Jaemin Shim, Yun Gi Kim, Kyongjin Min, Seung-Young Roh, Jin Seok Kim, Jong-Il Choi, Young-Hoon Kim
Summary: Adenosine-induced atrial fibrillation (AIAF) does not affect the long-term recurrence rate after pulmonary vein isolation (PVI). Additional ablation for the trigger site of AIAF does not improve clinical outcomes.
JOURNAL OF CLINICAL MEDICINE
(2022)
Review
Cardiac & Cardiovascular Systems
Malik Shehadeh, Elaine Y. Wan, Angelo Biviano, Reza Mollazadeh, Hasan Garan, Hirad Yarmohammadi
Summary: Esophageal perforation and fistula formation are rare but serious complications following atrial fibrillation ablation. The incidence of esophageal injury is higher with thermal ablation modalities. Monitoring esophageal temperature and mechanical esophageal deviation have protective effects in reducing the incidence of this complication.
JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY
(2023)
Article
Medicine, General & Internal
Jason G. Andrade, George A. Wells, Marc W. Deyell, Matthew Bennett, Vidal Essebag, Jean Champagne, Jean-Francois Roux, Derek Yung, Allan Skanes, Yaariv Khaykin, Carlos Morillo, Umjeet Jolly, Paul Novak, Evan Lockwood, Guy Amit, Paul Angaran, John Sapp, Stephan Wardell, Sandra Lauck, Laurent Macle, Atul Verma
Summary: In patients with symptomatic, paroxysmal atrial fibrillation, catheter cryoballoon ablation was associated with a significantly lower rate of atrial fibrillation recurrence compared to antiarrhythmic drug therapy. The ablation group also had better outcomes in terms of atrial tachyarrhythmia occurrence and atrial fibrillation burden.
NEW ENGLAND JOURNAL OF MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Jason G. Andrade, Marc W. Deyell, Paul Khairy, Jean Champagne, Peter Leong-Sit, Paul Novak, Lawrence Sterns, Jean-Francois Roux, John Sapp, Richard Bennett, Matthew Bennett, Nathaniel Hawkins, Prashanthan Sanders, Laurent Macle
Summary: Catheter ablation using radiofrequency energy for paroxysmal AF can reduce the risk of progression to persistent AF.
EUROPEAN HEART JOURNAL
(2023)
Article
Medicine, General & Internal
Rani Kronenberger, Ines Van Loo, Carlo de Asmundis, Maridi Aerts, Sandro Gelsomino, Vincent Umbrain, Gian-Battista Chierchia, Mark La Meir
Summary: In patients undergoing hybrid ablation, postoperative esophageal findings were studied to assess the risk of atrio-esophageal fistula. Novel preventive strategies were found to eliminate the potential risk of esophageal thermal lesions, highlighting the importance of comprehensive pre-operative screening in patients with preexisting esophageal disease.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Yuxia Miao, Min Xu, Ling Yang, Chunxu Zhang, Huannian Liu, Xiaoliang Shao
Summary: This study found a linear and positive association between P wave duration within 72 hours after radiofrequency ablation and the risk of atrial fibrillation recurrence in patients with early persistent atrial fibrillation. This association was consistent across different subgroups and there was no significant interaction.
INTERNATIONAL JOURNAL OF CARDIOLOGY
(2022)
Article
Multidisciplinary Sciences
Michifumi Tokuda, Seigo Yamashita, Hidenori Sato, Hirotsuna Oseto, Hirotsugu Ikewaki, Masaaki Yokoyama, Ryota Isogai, Ken-ichi Tokutake, Ken-ichi Yokoyama, Mika Kato, Ryohsuke Narui, Shin-ichi Tanigawa, Seiichiro Matsuo, Michihiro Yoshimura, Teiichi Yamane
Summary: While phrenic nerve palsy during cryoballoon ablation for atrial fibrillation is usually transient, some cases may persist for more than 4 years. The occurrence of phrenic nerve palsy is not predicted by the anatomy of the pulmonary veins, freezing parameters, or the operator's proficiency. Most patients recover from phrenic nerve palsy within one year, but a small percentage may have long-term effects.
SCIENTIFIC REPORTS
(2021)
