Mediastinal and esophageal injuries following radiofrequency ablation of atrial fibrillation

Aims: Radiofrequency (RF) catheter ablation is a potentially curative treatment of atrial fibrillation (AF). Esophageal wall changes varying from erythema up to ulcers following pulmonary vein isolation (PVI) have been described in up to 47% of the patients (Schmidt M. et al, Europace 2008). Although esophageal changes are frequently reported, the dramatic development of a left atrial-esophageal (LA-eso) fistula is rare. Nevertheless endoscopic visible esophageal lesions may just represent „the tip of the iceberg“. To the best of our knowledge mediastinal changes following PVI have not been studied by endosonogr…