Influence of proton pump inhibitors on the incidence and clinical course of oesophageal fistula following catheter ablation for atrial fibrillation: a subanalysis of the POTTER-AF study.
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Authors
Beiert T.
Knappe V.
Zietzer A.
Schmidt V.
Purerfellner H.
Sommer P.
Sohns C.
Veltmann C.
Steven D.
Chun K.R.J.
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Issue Date
2025
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Article
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Abstract
Atrial fibrillation (AF) represents the most common cardiac arrhythmia with an increasing incidence and prevalence worldwide.1 Pulmonary vein isolation (PVI) via catheter ablation is the cornerstone of AF treatment. Despite years of experience and significant technological advances, oesophageal fistula (OF) remains the most severe complication of catheter ablation for AF, associated with high morbidity and mortality. The POTTER-AF study reported a very low incidence of 0.025%. Therefore, data on effective preventive measures remain limited. Despite the lack of evidence, proton pump inhibitor (PPI) therapy is a widely adopted prophylactic treatment. While PPIs are considered to be generally well tolerated, recent studies have demonstrated relevant pharmacological interactions and adverse effects, warranting a cautious prescription. The aim of this study was to evaluate the impact of routine PPI use on the incidence and clinical course of OF in the POTTER-AF study.
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Journal
Europace
Volume
27
Issue
European Resuscitation Council Guidelines 2025.