Atrioesophageal Fistulae After Ablation for Atrial Fibrillation (AF): A Timely Approach to the Early Identification and Management of a Critical Complication

The occurrence of atrioesophageal fistulae (AEF) after ablative therapy for atrial fibrillation (AF) represents a rare yet frequently fatal complication, with mortality approaching 100% without prompt surgical intervention. Delayed intervention has been associated with devastating outcomes, underscoring the importance of early identification of this disease process, as well as rapid clinical decision-making and management. Key concepts in endoscopic management include avoidance of air insufflation during endoscopy and refraining from use of stents. The present article provides a comprehensive review of current strategies for timely diagnosis and appropriate, multidisciplinary management to mitigate the morbidity and mortality associated with this life-threatening process.