CC BY-NC-ND 4.0 · Thorac Cardiovasc Surg Rep 2022; 11(01): e27-e29
DOI: 10.1055/s-0041-1736209
Case Report: Cardiac

Pericardial–Esophageal Fistula: A Rare but Increasing Complication of Cardiac Ablation

Erik A. Sylvin
1   Division of Cardiothoracic Surgery, JFK Medical Center, University of Miami Miller School of Medicine, Atlantis, Florida, United States
Arminder S. Jassar
2   Division of Cardiac Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, United States
John C. Kucharczuk
3   Division of Thoracic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States
Prashanth Vallabhajosyula
4   Section of Cardiac Surgery, Yale University School of Medicine, New Haven, Connecticut, United States
› Author Affiliations


Pericardial–esophageal fistula and/or atrial–esophageal fistula after cardiac ablation is nearly universally fatal if not detected and treated expeditiously. This condition should be assumed and ruled out in anyone with a recent history of cardiac ablation presenting with signs of sepsis, pneumomediastinum, pneumopericardium, or chest pain. Computed tomography scan of the chest is a rapid and a sensitive diagnostic modality. Tenets of treatment and repair consist of preventing an air embolism, repairing the esophageal perforation and atrial defect, and interposing autologous tissue between the esophagus and heart.

Publication History

Received: 01 April 2021

Accepted: 16 June 2021

Article published online:
07 March 2022

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