Atrioesophageal fistulas are a rare complication of radiofrequency ablation (RFA) that requires rapid identification and emergent surgical repair to prevent morbidity and mortality. We report a case of a 32-year-old man with atrial fibrillation presenting with chest pain followed by rapidly progressive sepsis and embolic cerebrovascular accident 23 days after RFA. Subtle initially overlooked findings on multiple computed tomography caused a delay in diagnosis. Atrioesophageal fistulas remain diagnostically challenging. A high index of suspicion coupled with serial computed tomography of the chest with intravenous and oral contrast reviewed by a multimodal team is essential to make a timely diagnosis.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/pace.14496 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A Simple Way to Exclude a Lethal Complication Following Atrial Fibrillation Radiofrequency Ablation: A Case Report.
Pacing Clin Electrophysiol
December 2024
Department of Cardiology, University Hospital of Patras, Rion-Patras, Greece.
Esophageal injury is a serious complication following atrial fibrillation catheter ablation procedures. It may manifest as atrio-esophageal fistula, pericardio-esophageal fistula (PEF), or restricted perforation, with high mortality rate if left unoperated. Chest computed tomography with intravenous contrast is the mainstay of diagnosis; however, a definite imaging diagnosis is often delayed and may worsen patient outcomes.
View Article and Find Full Text PDFAlternative Operative Strategy in the Management of an Atrio-Esophageal Fistula.
Cureus
November 2024
Department of Cardiothoracic Surgery, Sarasota Memorial Health Care System, Sarasota, USA.
An atrio-esophageal fistula is a rare sequela of ablation. Standard approaches are associated with a high mortality. Atrial ablation resulting in an atrio-esophageal fistula is associated with exceedingly high mortality.
View Article and Find Full Text PDFWe report a case highlighting the global prevalence of atrial fibrillation (Afib) and the increased use of ablation therapy, underscoring the importance of understanding its complications, especially atrio-esophageal fistula (AEF), a rare but potentially fatal outcome. This case involves a 38-year-old male who underwent radiofrequency ablation for Afib and was subsequently hospitalized with abrupt left-sided weakness. Initially presumed to be a transient ischemic attack (TIA), his condition progressed to seizures and reduced consciousness.
View Article and Find Full Text PDFAtrioesophageal Fistula: A Rare, Life-Threatening Complication of Pulmonary Vein Isolation.
CASE (Phila)
October 2024
Department of Cardiology, Mayo Clinic, Rochester, Minnesota.
Article Synopsis
- - AEF is an uncommon but serious complication that can occur after PVI procedures.
- - The presence of free air in the left atrium or pericardium seen on chest CT helps confirm a diagnosis of AEF following PVI.
- - Standard treatment for AEF is urgent surgical repair, and potential complications can include strokes caused by emboli.
Utility of CT and MRI in Cardiac Electrophysiology.
Radiographics
September 2024
From the Mallinckrodt Institute of Radiology, Washington University, St. Louis, Mo (S.B.); Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minn (N.K., N.Y.T.); Banner University Medical Center, Phoenix, Ariz (M.F.M.); and Department of Radiology, Cardiovascular Imaging, Mayo Clinic, 200 1st Street SW, Rochester, MN 559905 (P.S.R.).
Cardiac electrophysiology involves the diagnosis and management of arrhythmias. CT and MRI play an increasingly important role in cardiac electrophysiology, primarily in preprocedural planning of ablation procedures but also in procedural guidance and postprocedural follow-up. The most common applications include ablation for atrial fibrillation (AF), ablation for ventricular tachycardia (VT), and for planning cardiac resynchronization therapy (CRT).
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!