Atrial-oesophageal fistula following percutaneous radiofrequency catheter ablation of atrial fibrillation: the risk still persists.

Autor:	Medeiros De Vasconcelos JT; Clinica de Ritmologia Cardiaca do Hospital Beneficência Portuguesa de São Paulo, São Paulo, SP, Brazil., Filho SDSG; Clinica de Ritmologia Cardiaca do Hospital Beneficência Portuguesa de São Paulo, São Paulo, SP, Brazil., Atié J; Clínica São Vicente and Hospital Universitário da Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil., Maciel W; Clínica São Vicente and Hospital Universitário da Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil., De Souza OF; Hospital Copa D'or - Rede D'or São Luiz, Rio de Janeiro, RJ, Brazil., Saad EB; Hospital Pró-Cardíaco, Rio de Janeiro, RJ, Brazil., Kalil CA; Hospital São Lucas da Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil., De Castro Mendonça R; Hospital São Lucas e Hospital Primavera, Aracaju, SE, Brazil., Araujo N; Hospital da UNIMED - RJ, Rio de Janeiro, RJ, Brazil., Pisani CF; Instituto do Coração da Universidade de São Paulo, São Paulo, SP, Brazil., Scanavacca MI; Instituto do Coração da Universidade de São Paulo, São Paulo, SP, Brazil.
Jazyk:	angličtina
Zdroj:	Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology [Europace] 2017 Feb 01; Vol. 19 (2), pp. 250-258.
DOI:	10.1093/europace/euw284
Abstrakt:	Aims: Atrial-oesophageal fistula is a serious complication related to ablation of atrial fibrillation. As its occurrence is rare, there is a great lack of information about their mechanisms, incidence, presentations, and treatment. The objective of this manuscript is to present a series of cases of atrial-oesophageal fistula in Brazil, focusing on incidence, clinical presentation, and follow-up. Methods and Results: This is a retrospective multicentre registry of atrial-oesophageal fistula cases that occurred in eight Brazilian centres from 2003 to 2015. Ten cases (0.113%) of atrial-oesophageal fistula were reported in 8863 ablation procedures in the period. Most of the subjects were male (70%) with age 59.6 ± 9.3 years. Eight centres were reference units in atrial fibrillation ablation with an experience over than 200 procedures at the time of fistula occurrence. Oesophageal temperature monitoring was performed in eight cases using coated sensors in six. The first atrial-oesophageal fistula clinical manifestation was typically fever (in six patients), with a median onset time of 16.5 (12–43) days after ablation. There was a delay of 7.8 ± 3.3 days between the first manifestation and the diagnosis in five patients. The treatment was surgical in six cases, clinical in three and stenting in one. Seven patients died (70%) and two developed permanent neurological sequelae. Conclusion: Atrial-oesophageal fistula remains a serious complication following AF ablation despite the incorporation of protective measures and increased technical experience of the groups. The high morbidity and mortality despite the treatment indicates the need to develop adequate preventive strategies. (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu