Contreras-Valdes et al evaluated patients who developed esophageal injury following radiofrequency catheter ablation for atrial fibrillation (AF). The authors are from Massachusetts General Hospital.


Patient selection: radiofrequency catheter ablation of atrial fibrillation


Esophageal endoscopy was performed 24 hours after the ablation if a temperature probe in the esophagus showed an intraluminal temperature >= 39°C.


The operator usually makes adjustments to the procedure to reduce risk if the temperature readings becomes too high. Continuing the procedure despite high temperatures would be a risk factor for injury.

Endoscopic Appearance






mucosal erythema and/or shallow desquamation

superficial lesion

usually heals within 10 days

ulceration with hemorrhage and/or fibrinoid material

deep lesion

median time to healing 14 days, with maximum 41 days


A rare complication of a deep ulcer is an atrioesophageal fistula.


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