Early-Stage Esophago-Mediastinal Fistula After Atrial Fibrillation Radiofrequency Ablation Successfully Treated With Endoscopic Vacuum Therapy.

BACKGROUND

Esophageal injury is a rare but potentially fatal complication of atrial fibrillation ablation, predominantly associated with thermal energy sources.

CASE SUMMARY: A 37-year-old man developed an esophago-mediastinal fistula after radiofrequency ablation for atrial fibrillation. An esophageal ulcer detected on routine post-ablation endoscopy progressed despite conservative management. Endoscopic vacuum therapy was instituted for 5 days, followed by endoscopic clip closure, resulting in complete healing without surgical intervention.

CONCLUSION

This case underscores the value of post-ablation esophageal surveillance and demonstrates endoscopic vacuum therapy as an effective, minimally invasive option for managing esophageal perforation after radiofrequency ablation.