Atrio-esophageal fistula - Revision history

Ostermayer: Marked this version for translation

2026-01-06T20:35:42Z

Marked this version for translation

← Older revision		Revision as of 20:35, 6 January 2026
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	<translate>		<translate>

	==Background==		==Background== <!--T:1-->

			<!--T:2-->
	[[File:Gray1032.png\|thumb\|Posterior view of the position and relation of the esophagus in the cervical region and in the posterior mediastinum.]]		[[File:Gray1032.png\|thumb\|Posterior view of the position and relation of the esophagus in the cervical region and in the posterior mediastinum.]]
	[[File:Layers of the GI Tract english.svg\|thumb\|Layers of the GI track: the mucosa, submucosa, muscularis, and serosa.]]		[[File:Layers of the GI Tract english.svg\|thumb\|Layers of the GI track: the mucosa, submucosa, muscularis, and serosa.]]
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	==Clinical Features==		==Clinical Features== <!--T:3-->

			<!--T:4-->
	*Most common presenting symptoms:		*Most common presenting symptoms:
	**[[Special:MyLanguage/Fever\|Fever]]		**[[Special:MyLanguage/Fever\|Fever]]
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	==Differential Diagnosis==		==Differential Diagnosis== <!--T:5-->

			<!--T:6-->
	*[[Special:MyLanguage/Sepsis\|Sepsis]]		*[[Special:MyLanguage/Sepsis\|Sepsis]]
	*[[Special:MyLanguage/Stroke\|Stroke]]/[[Special:MyLanguage/TIA\|TIA]]		*[[Special:MyLanguage/Stroke\|Stroke]]/[[Special:MyLanguage/TIA\|TIA]]
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	==Evaluation==		==Evaluation== <!--T:7-->

			<!--T:8-->
	[[File:PMC3631790 kjtcs-46-142-g003.png\|thumb\|Chest CT demonstrating pneumomediastinum after cardiac radiofrequency catheter ablation for refractory atrial fibrillation.]]		[[File:PMC3631790 kjtcs-46-142-g003.png\|thumb\|Chest CT demonstrating pneumomediastinum after cardiac radiofrequency catheter ablation for refractory atrial fibrillation.]]
	*CT chest with contrast is the recommended modality, but repeat testing may be needed for eventual diagnosis <ref> Han H-C, Hui-Chen Han From the Austin Health, Ha FJ, et al. Atrioesophageal Fistula. Circulation: Arrhythmia and Electrophysiology. https://www.ahajournals.org/doi/full/10.1161/CIRCEP.117.005579. Published November 6, 2017. Accessed December 14, 2020. </ref>		*CT chest with contrast is the recommended modality, but repeat testing may be needed for eventual diagnosis <ref> Han H-C, Hui-Chen Han From the Austin Health, Ha FJ, et al. Atrioesophageal Fistula. Circulation: Arrhythmia and Electrophysiology. https://www.ahajournals.org/doi/full/10.1161/CIRCEP.117.005579. Published November 6, 2017. Accessed December 14, 2020. </ref>
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	==Management==		==Management== <!--T:9-->

			<!--T:10-->
	*Mortality is high in all patients		*Mortality is high in all patients
	*Surgery has the best mortality benefit, followed by endoscopic intervention		*Surgery has the best mortality benefit, followed by endoscopic intervention
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	==Disposition==		==Disposition== <!--T:11-->

			<!--T:12-->
	*Admission		*Admission
	*Surgery consultation		*Surgery consultation


	==See Also==		==See Also== <!--T:13-->


	==External Links==		==External Links== <!--T:14-->


	==References==		==References== <!--T:15-->

			<!--T:16-->
	<references/>		<references/>

			<!--T:17-->
	[[Category:Surgery]]		[[Category:Surgery]]
	[[Category:Cardiology]]		[[Category:Cardiology]]
	[[Category:GI]]		[[Category:GI]]
	</translate>		</translate>

Ostermayer: Prepared the page for translation

2026-01-04T21:42:34Z

Prepared the page for translation

← Older revision		Revision as of 21:42, 4 January 2026
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			<languages/>
			<translate>

	==Background==		==Background==

	[[File:Gray1032.png\|thumb\|Posterior view of the position and relation of the esophagus in the cervical region and in the posterior mediastinum.]]		[[File:Gray1032.png\|thumb\|Posterior view of the position and relation of the esophagus in the cervical region and in the posterior mediastinum.]]
	[[File:Layers of the GI Tract english.svg\|thumb\|Layers of the GI track: the mucosa, submucosa, muscularis, and serosa.]]		[[File:Layers of the GI Tract english.svg\|thumb\|Layers of the GI track: the mucosa, submucosa, muscularis, and serosa.]]
	[[File:Illu esophagus.jpg\|thumb\|Esophagus anatomy and nomenclature based on two systems.]]		[[File:Illu esophagus.jpg\|thumb\|Esophagus anatomy and nomenclature based on two systems.]]
	[[File:PMC2922872 ipej100339-08.png\|thumb\|CT showing anatomic relationship between an enlarged left atrium (LA) and esophagus (ESO): atrium abuts and indents into the anterior wall of the esophagus.]]		[[File:PMC2922872 ipej100339-08.png\|thumb\|CT showing anatomic relationship between an enlarged left atrium (LA) and esophagus (ESO): atrium abuts and indents into the anterior wall of the esophagus.]]
	*Rare but deadly complication of atrial [[Cardiac ablation complications\|ablation]]		*Rare but deadly complication of atrial [[Special:MyLanguage/Cardiac ablation complications\|ablation]]
	*There have been reported cases with various ablation modalities (including radiofrequency ablation, cryoablation, high intensity focused ultrasound, and surgical ablation)		*There have been reported cases with various ablation modalities (including radiofrequency ablation, cryoablation, high intensity focused ultrasound, and surgical ablation)
	*Incidence is low (<0.1%) <ref> Nair KK, Danon A, Valaparambil A, Koruth JS, Singh SM. Atrioesophageal Fistula: A Review. J Atr Fibrillation. 2015;8(3):1331. Published 2015 Oct 31. doi:10.4022/jafib.1331 </ref>		*Incidence is low (<0.1%) <ref> Nair KK, Danon A, Valaparambil A, Koruth JS, Singh SM. Atrioesophageal Fistula: A Review. J Atr Fibrillation. 2015;8(3):1331. Published 2015 Oct 31. doi:10.4022/jafib.1331 </ref>
	*Usually formed between esophagus and left atrium		*Usually formed between esophagus and left atrium
	*Thought to be related to adverse healing secondary to esophageal injury during the ablation procedure		*Thought to be related to adverse healing secondary to esophageal injury during the ablation procedure


	==Clinical Features==		==Clinical Features==

	*Most common presenting symptoms:		*Most common presenting symptoms:
	**[[Fever]]		**[[Special:MyLanguage/Fever\|Fever]]
	**Neurological symptoms (including [[focal neurological symptoms]], [[seizure]], [[AMS]])		**Neurological symptoms (including [[Special:MyLanguage/focal neurological symptoms\|focal neurological symptoms]], [[Special:MyLanguage/seizure\|seizure]], [[Special:MyLanguage/AMS\|AMS]])
	**Gastrointestinal symptoms (including [[hematemesis]], [[melena]], [[dysphagia]], [[nausea/vomiting]])		**Gastrointestinal symptoms (including [[Special:MyLanguage/hematemesis\|hematemesis]], [[Special:MyLanguage/melena\|melena]], [[Special:MyLanguage/dysphagia\|dysphagia]], [[Special:MyLanguage/nausea/vomiting\|nausea/vomiting]])
	**[[Chest pain]]		**[[Special:MyLanguage/Chest pain\|Chest pain]]
	*Most common time frame to presentation is 2-4 weeks post procedure but can occur up to 2 months post procedure		*Most common time frame to presentation is 2-4 weeks post procedure but can occur up to 2 months post procedure


	==Differential Diagnosis==		==Differential Diagnosis==
	*[[Sepsis]]
	*[[Stroke]]/[[TIA]]		*[[Special:MyLanguage/Sepsis\|Sepsis]]
	*[[GI bleed]]		*[[Special:MyLanguage/Stroke\|Stroke]]/[[Special:MyLanguage/TIA\|TIA]]
			*[[Special:MyLanguage/GI bleed\|GI bleed]]
			</translate>
	{{Chest Pain DDX}}		{{Chest Pain DDX}}
			<translate>


	==Evaluation==		==Evaluation==

	[[File:PMC3631790 kjtcs-46-142-g003.png\|thumb\|Chest CT demonstrating pneumomediastinum after cardiac radiofrequency catheter ablation for refractory atrial fibrillation.]]		[[File:PMC3631790 kjtcs-46-142-g003.png\|thumb\|Chest CT demonstrating pneumomediastinum after cardiac radiofrequency catheter ablation for refractory atrial fibrillation.]]
	*CT chest with contrast is the recommended modality, but repeat testing may be needed for eventual diagnosis <ref> Han H-C, Hui-Chen Han From the Austin Health, Ha FJ, et al. Atrioesophageal Fistula. Circulation: Arrhythmia and Electrophysiology. https://www.ahajournals.org/doi/full/10.1161/CIRCEP.117.005579. Published November 6, 2017. Accessed December 14, 2020. </ref>		*CT chest with contrast is the recommended modality, but repeat testing may be needed for eventual diagnosis <ref> Han H-C, Hui-Chen Han From the Austin Health, Ha FJ, et al. Atrioesophageal Fistula. Circulation: Arrhythmia and Electrophysiology. https://www.ahajournals.org/doi/full/10.1161/CIRCEP.117.005579. Published November 6, 2017. Accessed December 14, 2020. </ref>
	*Endoscopy may be considered, but may be associated an increased risk of clinical deterioration		*Endoscopy may be considered, but may be associated an increased risk of clinical deterioration
	*Transthoracic and transesophageal echocardiography have not been found to be highly sensitive		*Transthoracic and transesophageal echocardiography have not been found to be highly sensitive


	==Management==		==Management==

	*Mortality is high in all patients		*Mortality is high in all patients
	*Surgery has the best mortality benefit, followed by endoscopic intervention		*Surgery has the best mortality benefit, followed by endoscopic intervention
	*Nonintervention has the worst outcome		*Nonintervention has the worst outcome


	==Disposition==		==Disposition==

	*Admission		*Admission
	*Surgery consultation		*Surgery consultation


	==See Also==		==See Also==


	==External Links==		==External Links==


	==References==		==References==

	<references/>		<references/>

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	[[Category:Cardiology]]		[[Category:Cardiology]]
	[[Category:GI]]		[[Category:GI]]
			</translate>

Rossdonaldson1: /* Background */

2024-02-07T22:26:52Z

Background

← Older revision		Revision as of 22:26, 7 February 2024
Line 1:		Line 1:
	==Background==		==Background==
			[[File:Gray1032.png\|thumb\|Posterior view of the position and relation of the esophagus in the cervical region and in the posterior mediastinum.]]
			[[File:Layers of the GI Tract english.svg\|thumb\|Layers of the GI track: the mucosa, submucosa, muscularis, and serosa.]]
			[[File:Illu esophagus.jpg\|thumb\|Esophagus anatomy and nomenclature based on two systems.]]
	[[File:PMC2922872 ipej100339-08.png\|thumb\|CT showing anatomic relationship between an enlarged left atrium (LA) and esophagus (ESO): atrium abuts and indents into the anterior wall of the esophagus.]]		[[File:PMC2922872 ipej100339-08.png\|thumb\|CT showing anatomic relationship between an enlarged left atrium (LA) and esophagus (ESO): atrium abuts and indents into the anterior wall of the esophagus.]]
	*Rare but deadly complication of atrial [[Cardiac ablation complications\|ablation]]		*Rare but deadly complication of atrial [[Cardiac ablation complications\|ablation]]

ClaireLewis at 15:46, 8 February 2021

2021-02-08T15:46:21Z

← Older revision		Revision as of 15:46, 8 February 2021
Line 1:		Line 1:
	==Background==		==Background==
	[[File:PMC2922872 ipej100339-08.png\|thumb\|CT showing anatomic relationship between an enlarged left atrium (LA) and esophagus (ESO): atrium abuts and indents into the anterior wall of the esophagus.]]		[[File:PMC2922872 ipej100339-08.png\|thumb\|CT showing anatomic relationship between an enlarged left atrium (LA) and esophagus (ESO): atrium abuts and indents into the anterior wall of the esophagus.]]
	*Rare but deadly complication of atrial ablation		*Rare but deadly complication of atrial [[Cardiac ablation complications\|ablation]]
	*There have been reported cases with various ablation modalities (including radiofrequency ablation, cryoablation, high intensity focused ultrasound, and surgical ablation)		*There have been reported cases with various ablation modalities (including radiofrequency ablation, cryoablation, high intensity focused ultrasound, and surgical ablation)
	*Incidence is low (<0.1%) <ref> Nair KK, Danon A, Valaparambil A, Koruth JS, Singh SM. Atrioesophageal Fistula: A Review. J Atr Fibrillation. 2015;8(3):1331. Published 2015 Oct 31. doi:10.4022/jafib.1331 </ref>		*Incidence is low (<0.1%) <ref> Nair KK, Danon A, Valaparambil A, Koruth JS, Singh SM. Atrioesophageal Fistula: A Review. J Atr Fibrillation. 2015;8(3):1331. Published 2015 Oct 31. doi:10.4022/jafib.1331 </ref>
Line 9:		Line 9:
	==Clinical Features==		==Clinical Features==
	*Most common presenting symptoms:		*Most common presenting symptoms:
	**Fever		**[[Fever]]
	**Neurological symptoms (including focal neurological symptoms, seizure, AMS)		**Neurological symptoms (including [[focal neurological symptoms]], [[seizure]], [[AMS]])
	**Gastrointestinal symptoms (including hematemesis, melena, dysphagia, nausea/vomiting)		**Gastrointestinal symptoms (including [[hematemesis]], [[melena]], [[dysphagia]], [[nausea/vomiting]])
	**Chest pain		**[[Chest pain]]
	*Most common time frame to presentation is 2-4 weeks post procedure but can occur up to 2 months post procedure		*Most common time frame to presentation is 2-4 weeks post procedure but can occur up to 2 months post procedure

	==Differential Diagnosis==		==Differential Diagnosis==
	*Sepsis		*[[Sepsis]]
	*Stroke/TIA		*[[Stroke]]/[[TIA]]
	*GI bleed		*[[GI bleed]]
	{{Chest Pain DDX}}		{{Chest Pain DDX}}

Rossdonaldson1: /* References */

2021-01-12T16:37:54Z

References

← Older revision		Revision as of 16:37, 12 January 2021
Line 44:		Line 44:

	[[Category:Surgery]]		[[Category:Surgery]]
			[[Category:Cardiology]]
			[[Category:GI]]

Rossdonaldson1 at 16:29, 12 January 2021

2021-01-12T16:29:30Z

← Older revision		Revision as of 16:29, 12 January 2021
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	*Surgery consultation		*Surgery consultation

			==See Also==

			==External Links==

	==References==		==References==
	<references/>		<references/>

			[[Category:Surgery]]

Rossdonaldson1: /* Background */

2021-01-12T16:28:07Z

Background

← Older revision		Revision as of 16:28, 12 January 2021
Line 1:		Line 1:
	==Background==		==Background==
			[[File:PMC2922872 ipej100339-08.png\|thumb\|CT showing anatomic relationship between an enlarged left atrium (LA) and esophagus (ESO): atrium abuts and indents into the anterior wall of the esophagus.]]
	*Rare but deadly complication of atrial ablation		*Rare but deadly complication of atrial ablation
	*There have been reported cases with various ablation modalities (including radiofrequency ablation, cryoablation, high intensity focused ultrasound, and surgical ablation)		*There have been reported cases with various ablation modalities (including radiofrequency ablation, cryoablation, high intensity focused ultrasound, and surgical ablation)

Rossdonaldson1: /* Evaluation */

2021-01-12T16:25:29Z

Evaluation

← Older revision		Revision as of 16:25, 12 January 2021
Line 21:		Line 21:

	==Evaluation==		==Evaluation==
			[[File:PMC3631790 kjtcs-46-142-g003.png\|thumb\|Chest CT demonstrating pneumomediastinum after cardiac radiofrequency catheter ablation for refractory atrial fibrillation.]]
	*CT chest with contrast is the recommended modality, but repeat testing may be needed for eventual diagnosis <ref> Han H-C, Hui-Chen Han From the Austin Health, Ha FJ, et al. Atrioesophageal Fistula. Circulation: Arrhythmia and Electrophysiology. https://www.ahajournals.org/doi/full/10.1161/CIRCEP.117.005579. Published November 6, 2017. Accessed December 14, 2020. </ref>		*CT chest with contrast is the recommended modality, but repeat testing may be needed for eventual diagnosis <ref> Han H-C, Hui-Chen Han From the Austin Health, Ha FJ, et al. Atrioesophageal Fistula. Circulation: Arrhythmia and Electrophysiology. https://www.ahajournals.org/doi/full/10.1161/CIRCEP.117.005579. Published November 6, 2017. Accessed December 14, 2020. </ref>
	*Endoscopy may be considered, but may be associated an increased risk of clinical deterioration		*Endoscopy may be considered, but may be associated an increased risk of clinical deterioration

SeanDenny: /* Evaluation */

2020-12-14T01:59:02Z

Evaluation

← Older revision		Revision as of 01:59, 14 December 2020
Line 22:		Line 22:
	==Evaluation==		==Evaluation==
	*CT chest with contrast is the recommended modality, but repeat testing may be needed for eventual diagnosis <ref> Han H-C, Hui-Chen Han From the Austin Health, Ha FJ, et al. Atrioesophageal Fistula. Circulation: Arrhythmia and Electrophysiology. https://www.ahajournals.org/doi/full/10.1161/CIRCEP.117.005579. Published November 6, 2017. Accessed December 14, 2020. </ref>		*CT chest with contrast is the recommended modality, but repeat testing may be needed for eventual diagnosis <ref> Han H-C, Hui-Chen Han From the Austin Health, Ha FJ, et al. Atrioesophageal Fistula. Circulation: Arrhythmia and Electrophysiology. https://www.ahajournals.org/doi/full/10.1161/CIRCEP.117.005579. Published November 6, 2017. Accessed December 14, 2020. </ref>
	*Endoscopy may be considered, but may be associated in increased risk of clinical deterioration		*Endoscopy may be considered, but may be associated an increased risk of clinical deterioration
	*Transthoracic and transesophageal echocardiography have not been found to be highly sensitive		*Transthoracic and transesophageal echocardiography have not been found to be highly sensitive

SeanDenny: /* Evaluation */

2020-12-14T01:58:41Z

Evaluation

← Older revision		Revision as of 01:58, 14 December 2020
Line 21:		Line 21:

	==Evaluation==		==Evaluation==
	*CT chest with contrast is recommended modality, but repeat testing may be needed for eventual diagnosis <ref> Han H-C, Hui-Chen Han From the Austin Health, Ha FJ, et al. Atrioesophageal Fistula. Circulation: Arrhythmia and Electrophysiology. https://www.ahajournals.org/doi/full/10.1161/CIRCEP.117.005579. Published November 6, 2017. Accessed December 14, 2020. </ref>		*CT chest with contrast is the recommended modality, but repeat testing may be needed for eventual diagnosis <ref> Han H-C, Hui-Chen Han From the Austin Health, Ha FJ, et al. Atrioesophageal Fistula. Circulation: Arrhythmia and Electrophysiology. https://www.ahajournals.org/doi/full/10.1161/CIRCEP.117.005579. Published November 6, 2017. Accessed December 14, 2020. </ref>
	*Endoscopy may be considered, but may be associated in increased risk of clinical deterioration		*Endoscopy may be considered, but may be associated in increased risk of clinical deterioration
	*Transthoracic and transesophageal echocardiography have not been found to be highly sensitive		*Transthoracic and transesophageal echocardiography have not been found to be highly sensitive

← Older revision		Revision as of 22:26, 7 February 2024
Line 1:		Line 1:
	==Background==		==Background==
			[[File:Gray1032.png\|thumb\|Posterior view of the position and relation of the esophagus in the cervical region and in the posterior mediastinum.]]
			[[File:Layers of the GI Tract english.svg\|thumb\|Layers of the GI track: the mucosa, submucosa, muscularis, and serosa.]]
			[[File:Illu esophagus.jpg\|thumb\|Esophagus anatomy and nomenclature based on two systems.]]
	[[File:PMC2922872 ipej100339-08.png\|thumb\|CT showing anatomic relationship between an enlarged left atrium (LA) and esophagus (ESO): atrium abuts and indents into the anterior wall of the esophagus.]]		[[File:PMC2922872 ipej100339-08.png\|thumb\|CT showing anatomic relationship between an enlarged left atrium (LA) and esophagus (ESO): atrium abuts and indents into the anterior wall of the esophagus.]]
	*Rare but deadly complication of atrial [[Cardiac ablation complications\|ablation]]		*Rare but deadly complication of atrial [[Cardiac ablation complications\|ablation]]