{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:09:16Z","timestamp":1792080556963,"version":"4.4.0"},"reference-count":66,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2015,6,2]]},"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Atrioesophageal fistula (AEF) is a rare but serious adverse event of atrial fibrillation (AF) ablation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify the clinical characteristics of AEF following ablation procedures for AF and determine the associated mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review of observational cases of AEF following ablation procedures for AF was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement protocol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>53 cases were identified. Mean age was 54\u00b113\u2005years; 73% (39\/53) of cases occurred in males. Mean interval between procedure and presentation was 20\u00b112\u2005days, ranging from 2 to 60\u2005days. AEF was observed in 12 patients who underwent surgical radiofrequency ablation (RFA) and in 41 patients with percutaneous RFA. Fever was the most common presenting symptom (n=44) followed by neurological deficits (n=27) and haematemesis (n=19). CT of the chest (n=27) was the preferred diagnostic test. Patients who did not receive a primary esophageal repair were more likely to have a deadly outcome (34% vs 83%; p&lt;0.05). No difference in mortality rate was found between patients who underwent surgical RFA when compared with percutaneous RFA (58% vs 56%; p=0.579). No association was found between onset of symptoms and mortality (19\u00b110 vs 23\u00b114\u2005days; p=0.355).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AEF following ablation procedures for AF is a serious complication with high mortality rates. Presenting symptoms most often include a triad of fever, neurological deficit and\/or haematemesis within 60\u2005days of procedure. The preferred diagnostic test is CT of the chest. The treatments of choice is surgical repair.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/openhrt-2015-000257","type":"journal-article","created":{"date-parts":[[2015,9,10]],"date-time":"2015-09-10T22:18:58Z","timestamp":1441923538000},"page":"e000257","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":113,"title":["Atrioesophageal fistula following ablation procedures for atrial fibrillation: systematic review of case reports"],"prefix":"10.1136","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6786-4952","authenticated-orcid":false,"given":"Patricia","family":"Chavez","sequence":"first","affiliation":[{"name":"Division of Cardiology, St Luke's\u2014Roosevelt Hospital Center, Mount Sinai Healthcare System, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franz H","family":"Messerli","sequence":"additional","affiliation":[{"name":"Division of Cardiology, St 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