Abstract
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.
Keywords
surgical ablation - esophageal - pericardium - cardiopulmonary bypass - CPB
