Early‐Stage Esophago‐Mediastinal Fistula After Atrial Fibrillation Radiofrequency Ablation Successfully Treated With Endoscopic Vacuum Therapy

Abstract

ABSTRACT Background Esophageal injury is a rare but potentially fatal complication of atrial fibrillation ablation, predominantly associated with thermal energy sources. Case Summary A 37‐year‐old man developed an esophago‐mediastinal fistula after radiofrequency ablation for atrial fibrillation. An esophageal ulcer detected on routine post‐ablation endoscopy progressed despite conservative management. Endoscopic vacuum therapy was instituted for 5 days, followed by endoscopic clip closure, resulting in complete healing without surgical intervention. Conclusion This case underscores the value of post‐ablation esophageal surveillance and demonstrates endoscopic vacuum therapy as an effective, minimally invasive option for managing esophageal perforation after radiofrequency ablation.