European Heart Journal, 2023, 44 (27), pp.2458-2469. ⟨10.1093/eurheartj/ehad250⟩
Abstract Aims Oesophageal fistula represents a rare but dreadful complication of atrial fibrillation catheter ablation. Data on its incidence, management, and outcome are sparse. Methods and results This international multicentre registry investigates the characteristics of oesophageal fistulae after treatment of atrial fibrillation by catheter ablation. A total of 553 729 catheter ablation procedures (radiofrequency: 62.9%, cryoballoon: 36.2%, other modalities: 0.9%) were performed, at 214 centres in 35 countries. In 78 centres 138 patients [0.025%, radiofrequency: 0.038%, cryoballoon: 0.0015% (P < 0.0001)] were diagnosed with an oesophageal fistula. Peri-procedural data were available for 118 patients (85.5%). Following catheter ablation, the median time to symptoms and the median time to diagnosis were 18 (7.75, 25; range: 0–60) days and 21 (15, 29.5; range: 2–63) days, respectively. The median time from symptom onset to oesophageal fistula diagnosis was 3 (1, 9; range: 0–42) days. The most common initial symptom was fever (59.3%). The diagnosis was established by chest computed tomography in 80.2% of patients. Oesophageal surgery was performed in 47.4% and direct endoscopic treatment in 19.8% and conservative treatment in 32.8% of patients. The overall mortality was 65.8%. Mortality following surgical (51.9%) or endoscopic treatment (56.5%) was significantly lower as compared to conservative management (89.5%) [odds ratio 7.463 (2.414, 23.072) P < 0.001]. Conclusion Oesophageal fistula after catheter ablation of atrial fibrillation is rare and occurs mostly with the use of radiofrequency energy rather than cryoenergy. Mortality without surgical or endoscopic intervention is exceedingly high.
Roland Richard Tilz, Vanessa Schmidt, Helmut Pürerfellner, Philippe Maury, K Chun, et al.. A worldwide survey on incidence, management, and prognosis of oesophageal fistula formation following atrial fibrillation catheter ablation: the POTTER-AF study. European Heart Journal, 2023, 44 (27), pp.2458-2469. ⟨10.1093/eurheartj/ehad250⟩ (lien externe). ⟨hal-04586477⟩ (lien externe)
Citations
APA
Tilz, R. R., Schmidt, V., Pürerfellner, H., Maury, P., Chun, K., Martinek, M., Sohns, C., Schmidt, B., Mandel, F., Gandjbakhch, E., Laredo, M., Gunawardene, M. A., Willems, S., Beiert, T., Borlich, M., Iden, L., Füting, A., Spittler, R., Gaspar, T., … Heeger, C.-H. (2023). A worldwide survey on incidence, management, and prognosis of oesophageal fistula formation following atrial fibrillation catheter ablation: the POTTER-AF study. In European Heart Journal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10344651
MLA
Tilz, Roland Richard, et al. “A Worldwide Survey on Incidence, Management, and Prognosis of Oesophageal Fistula Formation Following Atrial Fibrillation Catheter Ablation: the POTTER-AF Study.” European Heart Journal, Apr. 2023, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10344651.
Chicago
Tilz, Roland Richard, Vanessa Schmidt, Helmut Pürerfellner, Philippe Maury, K Chun, Martin Martinek, Christian Sohns, et al. 2023. “A Worldwide Survey on Incidence, Management, and Prognosis of Oesophageal Fistula Formation Following Atrial Fibrillation Catheter Ablation: the POTTER-AF Study.” European Heart Journal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10344651.
Harvard
Tilz, R.R. et al. (2023) “A worldwide survey on incidence, management, and prognosis of oesophageal fistula formation following atrial fibrillation catheter ablation: the POTTER-AF study,” European Heart Journal. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10344651.
ISO 690
TILZ, Roland Richard, SCHMIDT, Vanessa, PÜRERFELLNER, Helmut, MAURY, Philippe, CHUN, K, MARTINEK, Martin, SOHNS, Christian, SCHMIDT, Boris, MANDEL, Franck, GANDJBAKHCH, Estelle, LAREDO, Mikael, GUNAWARDENE, Melanie Anuscha, WILLEMS, Stephan, BEIERT, Thomas, BORLICH, Martin, IDEN, Leon, FÜTING, Anna, SPITTLER, Raphael, GASPAR, Thomas, RICHTER, Sergio, SCHADE, Anja, KUNISS, Malte, NEUMANN, Thomas, FRANCKE, Alexander, WUNDERLICH, Carsten, SHIN, Dong-In, MEININGHAUS, Dirk Grosse, FORESTI, Mike, BONSELS, Marc, REEK, David, WIEGAND, Uwe, BAUER, Alexander, METZNER, Andreas, ECKARDT, Lars, POPESCU, Sorin Ștefan, KRAHNEFELD, Olaf, STICHERLING, Christian, KÜHNE, Michael, NGUYEN, Dinh Quang, ROTEN, Laurent, SAGUNER, Ardan, LINZ, Dominik, VAN DER VOORT, Pepijn, MULDER, Bart, VIJGEN, Johan, ALMORAD, Alexandre, GUENANCIA, Charles, FAUCHIER, Laurent, BOVEDA, Serge, GREEF, y De, DA COSTA, Antoine, JAIS, Pierre, DERVAL, Nicolas, MILHEM, Antoine, JESEL, Laurence, GARCIA, Rodrigue, POTY, Hervé, KHOUEIRY, Ziad, SEITZ, Julien, LABORDERIE, Julien, MECHULAN, Alexis, BRIGADEAU, Francois, ZHAO, Alexandre, SALUDAS, Yannick, PIOT, Olivier, AHLUWALIA, Nikhil, MARTIN, Claire, CHEN, Jian, ANTOLIC, Bor, LEVENTOPOULOS, Georgios, ÖZCAN, Emin Evren, YORGUN, Hikmet, CAY, Serkan, YALIN, Kivanc, BOTROS, Maichel Sobhy, MAHMOUD, Ahmed Taher, JĘDRZEJCZYK-PATEJ, Ewa, INABA, Osamu, OKUMURA, Ken, EJIMA, Koichiro, KHAKPOUR, Houman, BOYLE, Noel, CATANZARO, John, REDDY, Vivek, MOHANTY, Sanghamitra, NATALE, Andrea, BLESSBERGER, Hermann, YANG, Bing, STEVENS, Irene, SOMMER, Philipp, VELTMANN, Christian, STEVEN, Daniel, VOGLER, Julia, KUCK, Karl-Heinz, MERINO, José Luis, KEELANI, Ahmad and HEEGER, Christian-H, 2023. A worldwide survey on incidence, management, and prognosis of oesophageal fistula formation following atrial fibrillation catheter ablation: the POTTER-AF study [en ligne]. April 2023. Disponible à l'adresse : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10344651