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C. Pappone, H. Oral, V. Santinelli, G. Vicedomini, C. C. Lang, F. Manguso, et al., “Atrio-Esophageal Fistula as a Complication of Percutaneous Transcatheter Ablation of Atrial Fibrillation,” Circulation, Vol. 109, No. 22, 2004, pp. 2724-2726.
http://dx.doi.org/10.1161/01.CIR.0000131866.44650.46

has been cited by the following article:

• TITLE: Successful Anesthetic Management for Surgical Repair of Atrio-Esophageal Fistula Following Radiofrequency Ablation for Atrial Fibrillation

  AUTHORS: Atsushi Yasuda, Paul H. Alfille, Lisa T. Wollman-Kliman

  KEYWORDS: Atrial Fibrillation; Radiofrequency Ablation; Complication; Atrio-Esophageal Fistula; Anesthetic Management

  JOURNAL NAME: Open Journal of Anesthesiology, Vol.3 No.8, October 14, 2013

  ABSTRACT: Introduction: Atrio-esophageal fistula is a rare but often fatal complication of radiofrequency ablation for atrial fibrillation. Here we report a successful case in anesthetic management of surgical repair of atrio-esophageal fistula. Case Report: The patient was a 56-year-old man status post radiofrequency ablation for atrial fibrillation one month before presenting with fever and symptoms and signs of cerebral emboli. He was diagnosed as having atrio-esophageal fistula, which required emergent surgical repair. In the operating room, rapid sequence induction was performed with avoidance of positive pressure ventilation before securing airway. Double lumen tube was used for lung isolation for left thoracotomy. Upon exploration, a small fistula was identified. Both atrial and esophageal defects were ligated and an intercostal muscle flap was placed. The patient’s heart rhythm was atrial flutter/atrial fibrillation with marginal hemodynamics during the procedure, but cardioversion was delayed until the fistula was repaired and no remaining air, blood clot or gastric content in the heart was confirmed by epicardial ultrasound. The patient tolerated the surgery and was transferred to ICU, intubated and ventilated. He recovered from surgery and was transferred to a rehabilitation hospital with residual expressive aphasia. Conclusion: We had a successful case in anesthetic management for surgical repair of atrio-esophageal fistula by preventing massive bleeding as well as multiple air embolization through the fistula.