A worldwide survey on incidence, management, and prognosis of oesophageal fistula formation following atrial fibrillation catheter ablation: the POTTER-AF study
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- Roland Richard Tilz
- Department of Rhythmology, University Heart Center Lübeck, University Hospital Schleswig-Holstein , Ratzeburger Allee 160, D-23538 Lübeck , Germany
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- Vanessa Schmidt
- Department of Rhythmology, University Heart Center Lübeck, University Hospital Schleswig-Holstein , Ratzeburger Allee 160, D-23538 Lübeck , Germany
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- Helmut Pürerfellner
- Ordensklinikum Linz Elisabethinen , Linz , Austria
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- Philippe Maury
- Department of Cardiology, University Hospital Rangueil , Toulouse , France
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- K R J ulian Chun
- MVZ CCB am Agaplesion Markus Krankenhaus , Frankfurt a.M. , Germany
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- Martin Martinek
- Ordensklinikum Linz Elisabethinen , Linz , Austria
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- Christian Sohns
- Kliniken für Elektrophysiologie/Rhythmologie, Herz- und Diabeteszentrum NRW, Universitätsklinik der Ruhr-Universität Bochum , Bad Oeynhausen , Germany
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- Boris Schmidt
- MVZ CCB am Agaplesion Markus Krankenhaus , Frankfurt a.M. , Germany
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- Franck Mandel
- Department of Cardiology, University Hospital Rangueil , Toulouse , France
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- Estelle Gandjbakhch
- Sorbonne Université, APHP, Pitié Salpêtrière University Hospital, Cardiology Institute , Paris , France
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- Mikael Laredo
- APHP, Pitié Salpêtrière University Hospital, Cardiology Institute , Paris , France
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- Melanie Anuscha Gunawardene
- Klinik für Kardiologie und Internistische Intensivmedizin, Asklepios Klinik St. Georg , Hamburg , Germany
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- Stephan Willems
- Klinik für Kardiologie und Internistische Intensivmedizin, Asklepios Klinik St. Georg , Hamburg , Germany
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- Thomas Beiert
- Heart Center Bonn, Department of Internal Medicine II, University Hospital Bonn , Bonn , Germany
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- Martin Borlich
- Heart Center, Segeberger Kliniken (Academic Teaching Hospital of the Universities of Kiel, Lübeck and Hamburg), Bad Segeberg , Schleswig-Holstein , Germany
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- Leon Iden
- Heart Center, Segeberger Kliniken (Academic Teaching Hospital of the Universities of Kiel, Lübeck and Hamburg), Bad Segeberg , Schleswig-Holstein , Germany
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- Anna Füting
- Department of Electrophysiology, Alfred Krupp Hospital , Essen Germany
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- Raphael Spittler
- Department of Cardiology II/Electrophysiology, Center for Cardiology, University Hospital Mainz , Mainz , Germany
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- Thomas Gaspar
- Department of Internal and Cardiovascular Medicine, Herzzentrum Dresden, University Clinic, Technische Universität Dresden , Dresden , Germany
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- Sergio Richter
- Department of Internal and Cardiovascular Medicine, Herzzentrum Dresden, University Clinic, Technische Universität Dresden , Dresden , Germany
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- Anja Schade
- Department of Interventional Electrophysiology, Helios Hospital Erfurt , Erfurt , Germany
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- Malte Kuniss
- Department of Cardiology Kerckhoff Heart Center , Bad Nauheim , Germany
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- Thomas Neumann
- Department of Cardiology Kerckhoff Heart Center , Bad Nauheim , Germany
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- Alexander Francke
- Helios Klinikum Pirna, Klinik für Innere Medizin II , Pirna , Germany
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- Carsten Wunderlich
- Helios Klinikum Pirna, Klinik für Innere Medizin II , Pirna , Germany
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- Dong-In Shin
- Department of Cardiology, Heart Centre Niederrhein, Helios Clinic Krefeld , Krefeld , Germany
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- Dirk Grosse Meininghaus
- Department of Cardiology, Carl-Thiem-Klinikum gGmbH Cottbus , Cottbus , Germany
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- Mike Foresti
- Kliniken Maria Hilf GmbH , Mönchengladbach , Germany
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- Marc Bonsels
- Kliniken Maria Hilf GmbH , Mönchengladbach , Germany
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- David Reek
- Department of Cardiology, University Hospital Augsburg , Augsburg , Germany
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- Uwe Wiegand
- Sana-Klinikum Remscheid GmbH, Akademisches Lehrkrankenhaus der Universität zu Köln , Remscheid , Germany
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- Alexander Bauer
- Diak-Klinikum Schwäbisch Hall und Klinikum Crailsheim , Schwäbisch Hall , Germany
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- Andreas Metzner
- Universitäres Herz- und Gefäßzentrum, Klinik für Kardiologie, Universitätsklinikum Hamburg-Eppendorf , Hamburg , Germany
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- Lars Eckardt
- Department of Cardiology II (Electrophysiology), University Hospital Münster , Germany
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- Sorin Ștefan Popescu
- Department of Rhythmology, University Heart Center Lübeck, University Hospital Schleswig-Holstein , Ratzeburger Allee 160, D-23538 Lübeck , Germany
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- Olaf Krahnefeld
- Sana Kliniken Lübeck , Lübeck , Germany
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- Christian Sticherling
- Deaprtment of Cardiology, University Hospital Basel , Münster , Switzerland
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- Michael Kühne
- Deaprtment of Cardiology, University Hospital Basel , Münster , Switzerland
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- Dinh Quang Nguyen
- St. Vinzenz-Hospital Köln , Köln , Germany
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- Laurent Roten
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern , Basel , Switzerland
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- Ardan M Saguner
- Department of Cardiology, University Heart Center, University Hospital Zurich , Zurich , Switzerland
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- Dominik Linz
- Department of Cardiology, Maastricht University Medical Center and Cardiovascular Research Institute Maastricht , Maastricht , The Netherlands
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- Pepijn van der Voort
- Catharina Hospital , Eindhoven , The Netherlands
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- Bart A Mulder
- Department of Cardiology, University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
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- Johan Vijgen
- Heart Center Hasselt, Jessa Hospital , Hasselt , Belgium
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- Alexandre Almorad
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, European Reference Networks Guard-Heart , Brussels , Belgium
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- Charles Guenancia
- Cardiology Department, Dijon University Hospital , Dijon , France
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- Laurent Fauchier
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau , Tours , France
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- Serge Boveda
- Cardiology—Heart Rhythm Management Department, Clinique Pasteur , Toulouse , France
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- Y De Greef
- Department of Cardiology, ZNA Heart Centre , Antwerp , Belgium
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- Antoine Da Costa
- Division of Cardiology, Jean Monnet University , Saint-Etienne, Créteil , France
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- Pierre Jais
- CHU Bordeaux, Univ. Bordeaux, IHU LIRYC ANR-10-IAHU-04 , France
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- Nicolas Derval
- CHU Bordeaux, Univ. Bordeaux, IHU LIRYC ANR-10-IAHU-04 , France
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- Antoine Milhem
- La Rochelle Hospital , France
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- Laurence Jesel
- University Hospital Strasbourg , France
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- Rodrigue Garcia
- University Hospital Poitier , France
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- Hervé Poty
- Clinique Tonkin , Lyon , France
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- Ziad Khoueiry
- Clinique Saint Pierre , Perpignan , France
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- Julien Seitz
- Hospital St. Joseph , Marseille , France
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- Julien Laborderie
- Bayonne Hospital , France
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- Alexis Mechulan
- Hospital Clairval , Marseille , France
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- Francois Brigadeau
- University Hospital Lille , France
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- Alexandre Zhao
- Clinique Ambroise Parée , Paris , France
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- Yannick Saludas
- Clinique Pôle Santé République , Clermont Ferrand , France
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- Olivier Piot
- Centre Cardiologie du Nord , Saint Denis , France
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- Nikhil Ahluwalia
- Barts Heart Centre, Barts Health NHS Trust , London , UK
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- Claire Martin
- Royal Papworth Hospital , Cambridge , UK
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- Jian Chen
- Department of Heart Disease, Haukeland University Hospital, University of Bergen , Bergen , Norway
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- Bor Antolic
- Department of Cardiology, University Medical Center Ljubljana , Slovenia
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- Georgios Leventopoulos
- University of Patras , Greece
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- Emin Evren Özcan
- Heart Rhythm Management Center, Dokuz Eylul University , Izmir , Turkey
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- Hikmet Yorgun
- Department of Cardiology, Hacettepe University , Ankara , Turkey
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- Serkan Cay
- Department of Cardiology, Division of Arrhythmia and Electrophysiology, University of Health Sciences, Yuksek Ihtisas Cardiovascular Building, Ankara City Hospital , Ankara , Turkey
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- Kivanc Yalin
- Cerrahpasa Faculty of Medicine, Department of Cardiology, Istanbul University-Cerrahpasa , Istanbul , Turkey
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- Maichel Sobhy Botros
- Department of critical care medicine, Faculty of medicine, Cairo University , Cairo , Egypt
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- Ahmed Taher Mahmoud
- Department of critical care medicine, Faculty of medicine, Cairo University , Cairo , Egypt
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- Ewa Jędrzejczyk-Patej
- Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Centre for Heart Diseases , Zabrze , Poland
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- Osamu Inaba
- Department of Cardiology, Japanese Red Cross Saitama Hospital , Japan
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- Ken Okumura
- Division of Cardiology, Saiseikai Kumamoto Hospital , Kumamoto , Japan
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- Koichiro Ejima
- Department of Cardiology, Tokyo Women’s Medical University, Shinjuku-ku , Tokyo , Japan
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- Houman Khakpour
- UCLA Cardiac Arrhythmia Center , Los Angeles , USA
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- Noel Boyle
- UCLA Cardiac Arrhythmia Center , Los Angeles , USA
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- John N Catanzaro
- University of Florida Health , Jacksonville, FL , USA
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- Vivek Reddy
- Icahn School of Medicine at Mount Sinai , New York, NY , USA
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- Sanghamitra Mohanty
- St. David’s Medical Center, Texas Cardiac Arrhythmia Institute , Austin, TX , USA
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- Andrea Natale
- St. David’s Medical Center, Texas Cardiac Arrhythmia Institute , Austin, TX , USA
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- Hermann Blessberger
- Department of Cardiology, Kepler University Hospital , Linz , Austria
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- Bing Yang
- Department of Cardiology, Shanghai East Hospital, Tongji University , Shanghai , China
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- Irene Stevens
- Department of Rhythmology, University Heart Center Lübeck, University Hospital Schleswig-Holstein , Ratzeburger Allee 160, D-23538 Lübeck , Germany
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- Philipp Sommer
- Kliniken für Elektrophysiologie/Rhythmologie, Herz- und Diabeteszentrum NRW, Universitätsklinik der Ruhr-Universität Bochum , Bad Oeynhausen , Germany
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- Christian Veltmann
- Heart Center Bremen, Electrophysiology Bremen , Bremen , Germany
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- Daniel Steven
- Department for Electrophysiology, Heart Center University Cologne , Cologne , Germany
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- Julia Vogler
- Department of Rhythmology, University Heart Center Lübeck, University Hospital Schleswig-Holstein , Ratzeburger Allee 160, D-23538 Lübeck , Germany
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- Karl-Heinz Kuck
- Department of Rhythmology, University Heart Center Lübeck, University Hospital Schleswig-Holstein , Ratzeburger Allee 160, D-23538 Lübeck , Germany
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- José Luis Merino
- La Paz University Hospital, Universidad Autónoma de Madrid, Idipaz , Madrid , Spain
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- Ahmad Keelani
- Department of Rhythmology, University Heart Center Lübeck, University Hospital Schleswig-Holstein , Ratzeburger Allee 160, D-23538 Lübeck , Germany
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- Christian-H Heeger
- Department of Rhythmology, University Heart Center Lübeck, University Hospital Schleswig-Holstein , Ratzeburger Allee 160, D-23538 Lübeck , Germany
抄録
<jats:title>Abstract</jats:title><jats:sec><jats:title>Aims</jats:title><jats:p>Oesophageal fistula represents a rare but dreadful complication of atrial fibrillation catheter ablation. Data on its incidence, management, and outcome are sparse.</jats:p></jats:sec><jats:sec><jats:title>Methods and results</jats:title><jats:p>This international multicentre registry investigates the characteristics of oesophageal fistulae after treatment of atrial fibrillation by catheter ablation. A total of 553 729 catheter ablation procedures (radiofrequency: 62.9%, cryoballoon: 36.2%, other modalities: 0.9%) were performed, at 214 centres in 35 countries. In 78 centres 138 patients [0.025%, radiofrequency: 0.038%, cryoballoon: 0.0015% (P < 0.0001)] were diagnosed with an oesophageal fistula. Peri-procedural data were available for 118 patients (85.5%). Following catheter ablation, the median time to symptoms and the median time to diagnosis were 18 (7.75, 25; range: 0–60) days and 21 (15, 29.5; range: 2–63) days, respectively. The median time from symptom onset to oesophageal fistula diagnosis was 3 (1, 9; range: 0–42) days. The most common initial symptom was fever (59.3%). The diagnosis was established by chest computed tomography in 80.2% of patients. Oesophageal surgery was performed in 47.4% and direct endoscopic treatment in 19.8% and conservative treatment in 32.8% of patients. The overall mortality was 65.8%. Mortality following surgical (51.9%) or endoscopic treatment (56.5%) was significantly lower as compared to conservative management (89.5%) [odds ratio 7.463 (2.414, 23.072) P < 0.001].</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Oesophageal fistula after catheter ablation of atrial fibrillation is rare and occurs mostly with the use of radiofrequency energy rather than cryoenergy. Mortality without surgical or endoscopic intervention is exceedingly high.</jats:p></jats:sec>
収録刊行物
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- European Heart Journal
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European Heart Journal 44 (27), 2458-2469, 2023-04-16
Oxford University Press (OUP)