Surgical management of atrioesophageal fistula after catheter ablation of atrial fibrillation: A French nationwide study
2024

Surgical Management of Atrial Fistula After Catheter Ablation

Sample size: 18 publication 10 minutes Evidence: moderate

Author Information

Author(s): Dupautet Ludovic MD, Lebreton Guillaume MD, PhD, Saiydoun Gabriel MD, Bourguignon Thierry MD, PhD, Frey Sébastien MD, Beaufreton Christophe MD, PhD, Galvaing Géraud MD, MSc, Cambier Sébastien MD, MSc, Filaire Marc MD, PhD, Filaire Laura MD, MSc

Primary Institution: Centre Jean Perrin, Clermont-Ferrand, France

Hypothesis

The study aimed to assess the efficacy of different surgical strategies for atrioesophageal fistula after catheter ablation of atrial fibrillation.

Conclusion

Aggressive surgical strategies for managing atrioesophageal fistula are mandatory to offer the best chance of survival.

Supporting Evidence

  • Overall survival was 50% among the 18 patients studied.
  • Esophagectomy showed a tendency to offer a survival benefit.
  • Sepsis and neurological failure were identified as significant risk factors for mortality.

Takeaway

This study looked at how to treat a serious problem that can happen after heart surgery, and found that more aggressive surgery can help patients survive better.

Methodology

A retrospective observational cohort study was conducted analyzing patients with atrioesophageal or pericardo-esophageal fistula after catheter ablation of atrial fibrillation from a national database.

Potential Biases

Selection bias due to nonresponse from approximately two-thirds of cardiothoracic centers.

Limitations

The study had a small sample size and potential selection bias due to nonresponse from many centers.

Participant Demographics

Mean age was 58 years, with 88.9% male participants.

Statistical Information

P-Value

.0057

Confidence Interval

95% CI, 0.95-25.22

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1016/j.xjon.2024.09.010

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