Atrio-esophageal fistula

Last revised by Yuranga Weerakkody on 12 Aug 2023

Atrio-esophageal fistulas are rare pathological connections between the left atrium and the esophagus

The presentation is non-specific. Patients may complain of fever, malaise, and/or dysphagia, or present with neurological symptoms 3

The chief cause of atrial-esophageal fistulas is iatrogenic in the setting of cardiac ablation procedures (e.g. PVI ablation), although, theoretically, many mediastinal pathology or procedure could potentially cause a fistula.

CT is the modality of choice and may reveal communication between the left atrium and the esophagus which can be evidenced by IV contrast present in the esophagus.

Other possible features include:

The treatment is surgical, including resection and repair of the necrotic heart tissue and esophageal resection of the fistulous area. Esophageal stenting can be used as a temporizing measure. The mortality rate is high at ~60% (range 40-80%).

ADVERTISEMENT: Supporters see fewer/no ads

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.