Atrioesophageal fistula: A rare complication of catheter ablation for atrial fibrillation

Atrioesophageal fistula with resulting air emboli is a rare but potentially fatal complication of radiofrequency catheter ablation (RFCA) for atrial fibrillation. Patients typically present within 60 days after RFCA with fever, neurologic deficits, chest pain, and gastrointestinal bleeding. Chest CT with IV contrast reveals the atrioesophageal fistula in most cases, and CT of the head or MRI of the brain commonly reveals signs of air emboli. Early diagnosis, initiation of antibiotics, and immediate surgical intervention may improve patients' chances of survival.