Left atrio-oesophageal fistula after atrial fibrillation ablation.
Vishesh PaulRajamurugan MeenakshisundaramAbdur R JamalTalha Bin FarooqPublished in: BMJ case reports (2020)
We report a case of a 68-year-old woman who presented with atypical chest pain and fluctuating neurological symptoms 4 weeks after cryoballoon ablation procedure for atrial fibrillation. Brain imaging showed multiple embolic infarcts, while the chest imaging revealed an abnormal connection between the posterior wall of the left atrium and the oesophagus. Based on her clinical presentation and the imaging findings, a diagnosis of left atrio-oesophageal fistula (AOF) was established. AOF carries a high mortality rate unless an urgent surgical repair is performed. Oesophageal instrumentation for an echocardiogram or endoscopy should be avoided as it can result in massive air embolus, causing stroke or death.
Keyphrases
- atrial fibrillation
- catheter ablation
- high resolution
- left atrial appendage
- left atrial
- oral anticoagulants
- direct oral anticoagulants
- radiofrequency ablation
- type diabetes
- risk factors
- brain injury
- fluorescence imaging
- multiple sclerosis
- mass spectrometry
- blood brain barrier
- cardiovascular events
- pulmonary embolism
- acute coronary syndrome
- coronary artery disease