Severe Esophageal Complications Following Atrial Fibrillation Ablation: Should We Still Be Concerned?

Atrial fibrillation (AF) ablation has been increasingly employed as an effective strategy for rhythm control, leading to a reduction in arrhythmia burden, improved quality of life, and, in selected cases, decreased mortality. However, as an invasive procedure, it carries inherent risks. Severe esoph...

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Autores: Borges, Anibal Pires, Kalil, Carlos, Brugada, Josep, Yanez, Jose Plutarco Gutierrez, Soliz, Pablo da Costa, Saffi, Marco Aurelio Lumertz, da Silveira, Anderson Donelli, Pimentel, Mauricio
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Fundació Sant Joan de Déu
Repositorio:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
OAI Identifier:oai:fsjd.fundanetsuite.com:p29916
Acceso en línea:https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=29916
Access Level:acceso abierto
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spelling Severe Esophageal Complications Following Atrial Fibrillation Ablation: Should We Still Be Concerned?Borges, Anibal PiresKalil, CarlosBrugada, JosepYanez, Jose Plutarco GutierrezSoliz, Pablo da CostaSaffi, Marco Aurelio Lumertzda Silveira, Anderson DonelliPimentel, MauricioAtrial fibrillation (AF) ablation has been increasingly employed as an effective strategy for rhythm control, leading to a reduction in arrhythmia burden, improved quality of life, and, in selected cases, decreased mortality. However, as an invasive procedure, it carries inherent risks. Severe esophageal complications-such as esophageal perforation or atrioesophageal fistula- though rare (with an incidence ranging from 0.025% to 0.113%), are associated with significant morbidity and mortality. Multiple risk factors for esophageal injury have been identified, including both patient-related and procedure-related characteristics. To mitigate these risks during radiofrequency (RF) ablation, several preventive measures have been adopted, including the use of contact force catheters, high-power short-duration energy applications, and protective strategies such as esophageal temperature monitoring, displacement devices, and cooling techniques. Deep esophageal lesions detected through surveillance endoscopy are considered potential precursors to more serious complications and, therefore, warrant close attention. Enhanced monitoring of patients with such lesions may be crucial for enabling early diagnosis and timely intervention to prevent the progression to more severe complications. While pulsed field ablation therapy, which poses a lower risk to the esophagus and other surrounding structures, is not yet widely available, the implementation of robust monitoring strategies can significantly improve clinical outcomes and enhance patient safety in the context of RF AF ablation.ARQUIVOS BRASILEIROS CARDIOLOGIA2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=29916Arquivos Brasileiros de CardiologiaISSN: 0066782XISSNe: 16784170reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déuinstname:Fundació Sant Joan de DéuPortuguésinfo:eu-repo/semantics/openAccessoai:fsjd.fundanetsuite.com:p299162026-05-27T12:37:41Z
dc.title.none.fl_str_mv Severe Esophageal Complications Following Atrial Fibrillation Ablation: Should We Still Be Concerned?
title Severe Esophageal Complications Following Atrial Fibrillation Ablation: Should We Still Be Concerned?
spellingShingle Severe Esophageal Complications Following Atrial Fibrillation Ablation: Should We Still Be Concerned?
Borges, Anibal Pires
title_short Severe Esophageal Complications Following Atrial Fibrillation Ablation: Should We Still Be Concerned?
title_full Severe Esophageal Complications Following Atrial Fibrillation Ablation: Should We Still Be Concerned?
title_fullStr Severe Esophageal Complications Following Atrial Fibrillation Ablation: Should We Still Be Concerned?
title_full_unstemmed Severe Esophageal Complications Following Atrial Fibrillation Ablation: Should We Still Be Concerned?
title_sort Severe Esophageal Complications Following Atrial Fibrillation Ablation: Should We Still Be Concerned?
dc.creator.none.fl_str_mv Borges, Anibal Pires
Kalil, Carlos
Brugada, Josep
Yanez, Jose Plutarco Gutierrez
Soliz, Pablo da Costa
Saffi, Marco Aurelio Lumertz
da Silveira, Anderson Donelli
Pimentel, Mauricio
author Borges, Anibal Pires
author_facet Borges, Anibal Pires
Kalil, Carlos
Brugada, Josep
Yanez, Jose Plutarco Gutierrez
Soliz, Pablo da Costa
Saffi, Marco Aurelio Lumertz
da Silveira, Anderson Donelli
Pimentel, Mauricio
author_role author
author2 Kalil, Carlos
Brugada, Josep
Yanez, Jose Plutarco Gutierrez
Soliz, Pablo da Costa
Saffi, Marco Aurelio Lumertz
da Silveira, Anderson Donelli
Pimentel, Mauricio
author2_role author
author
author
author
author
author
author
description Atrial fibrillation (AF) ablation has been increasingly employed as an effective strategy for rhythm control, leading to a reduction in arrhythmia burden, improved quality of life, and, in selected cases, decreased mortality. However, as an invasive procedure, it carries inherent risks. Severe esophageal complications-such as esophageal perforation or atrioesophageal fistula- though rare (with an incidence ranging from 0.025% to 0.113%), are associated with significant morbidity and mortality. Multiple risk factors for esophageal injury have been identified, including both patient-related and procedure-related characteristics. To mitigate these risks during radiofrequency (RF) ablation, several preventive measures have been adopted, including the use of contact force catheters, high-power short-duration energy applications, and protective strategies such as esophageal temperature monitoring, displacement devices, and cooling techniques. Deep esophageal lesions detected through surveillance endoscopy are considered potential precursors to more serious complications and, therefore, warrant close attention. Enhanced monitoring of patients with such lesions may be crucial for enabling early diagnosis and timely intervention to prevent the progression to more severe complications. While pulsed field ablation therapy, which poses a lower risk to the esophagus and other surrounding structures, is not yet widely available, the implementation of robust monitoring strategies can significantly improve clinical outcomes and enhance patient safety in the context of RF AF ablation.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
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url https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=29916
dc.language.none.fl_str_mv Portugués
language_invalid_str_mv Portugués
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ARQUIVOS BRASILEIROS CARDIOLOGIA
publisher.none.fl_str_mv ARQUIVOS BRASILEIROS CARDIOLOGIA
dc.source.none.fl_str_mv Arquivos Brasileiros de Cardiologia
ISSN: 0066782X
ISSNe: 16784170
reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
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