Esophago‐pericardial fistula after catheter ablation of atrial fibrillation: A review

Introduction Much have been reported about esophago‐left atrium fistula. However, esophago‐mediastinal fistula, not reaching the left atrium, has not been studied as a different clinical entity, with different management. Methods and Results We review and discuss the literature of esophago‐mediastinum fistula after catheter ablation for atrial fibrillation with emphasis on the following points: the timing of its occurrence after ablation; the mechanisms and localization of the fistula; and its natural history. Conclusion We showed that esophageal stenting was associated with a better outcome in patients with esophagus‐mediastinal fistula, introduced the concept of left atrial wall weakening during ablation, and suggest a possible role of contact force use in fistula formation.