Limitations of esophageal temperature-monitoring to prevent esophageal injury during atrial fibrillation ablation.

A number of complications have been associated with ablation of atrial fibrillation (AF), including arterial thrombo-embolism, pulmonary vein stenosis, phrenic nerve injury, and pericardial tamponade.1–4 Esophageal injury, manifested as esophageal perforation or left atrial-esophageal fistula, has been reported after catheter or surgical ablation of AF using radiofrequency (RF) current5–8 and catheter ablation using high-intensity focused ultrasound (HIFU).9 Left atrial-esophageal fistula usually is associated with a very high morbidity and mortality, including air embolism and sepsis.