Left atrio-oesophageal fistula after atrial fibrillation ablation
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 t...
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| Veröffentlicht in: | BMJ case reports 2020-12, Vol.13 (12), p.e232508 |
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| creator | Paul, Vishesh Meenakshisundaram, Rajamurugan Jamal, Abdur R Bin Farooq, Talha |
| description | 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. |
| doi_str_mv | 10.1136/bcr-2019-232508 |
| format | Article |
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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.</description><identifier>ISSN: 1757-790X</identifier><identifier>EISSN: 1757-790X</identifier><identifier>DOI: 10.1136/bcr-2019-232508</identifier><identifier>PMID: 33298473</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd</publisher><subject>Ablation ; adult intensive care ; Aged ; Antibiotics ; Atrial Fibrillation - therapy ; Brain research ; Cardiac arrhythmia ; Case Report ; Case reports ; Catheter Ablation - adverse effects ; Catheters ; Emergency medical care ; Endoscopy ; Esophageal Fistula - diagnosis ; Esophageal Fistula - etiology ; Female ; Fever ; Fistula ; Fistula - diagnosis ; Fistula - etiology ; Heart Atria ; Heart Diseases - diagnosis ; Heart Diseases - etiology ; Humans ; Injuries ; Magnetic Resonance Imaging ; Mortality ; Ostomy ; pacing and electrophysiology ; Parenteral nutrition ; Patients ; Stroke ; Stroke - diagnosis ; Tomography, X-Ray Computed ; Ultrasonic imaging</subject><ispartof>BMJ case reports, 2020-12, Vol.13 (12), p.e232508</ispartof><rights>BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2020 BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ. 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-b446t-9b574586cd29aaf04cd92a61743ec8ba5340a41eebee28704348785dd7a736db3</cites><orcidid>0000-0002-9266-4212</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7733085/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7733085/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33298473$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Paul, Vishesh</creatorcontrib><creatorcontrib>Meenakshisundaram, Rajamurugan</creatorcontrib><creatorcontrib>Jamal, Abdur R</creatorcontrib><creatorcontrib>Bin Farooq, Talha</creatorcontrib><title>Left atrio-oesophageal fistula after atrial fibrillation ablation</title><title>BMJ case reports</title><addtitle>BMJ Case Rep</addtitle><addtitle>BMJ Case Rep</addtitle><description>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.</description><subject>Ablation</subject><subject>adult intensive care</subject><subject>Aged</subject><subject>Antibiotics</subject><subject>Atrial Fibrillation - therapy</subject><subject>Brain research</subject><subject>Cardiac arrhythmia</subject><subject>Case Report</subject><subject>Case reports</subject><subject>Catheter Ablation - adverse effects</subject><subject>Catheters</subject><subject>Emergency medical care</subject><subject>Endoscopy</subject><subject>Esophageal Fistula - diagnosis</subject><subject>Esophageal Fistula - etiology</subject><subject>Female</subject><subject>Fever</subject><subject>Fistula</subject><subject>Fistula - diagnosis</subject><subject>Fistula - etiology</subject><subject>Heart Atria</subject><subject>Heart Diseases - diagnosis</subject><subject>Heart Diseases - etiology</subject><subject>Humans</subject><subject>Injuries</subject><subject>Magnetic Resonance Imaging</subject><subject>Mortality</subject><subject>Ostomy</subject><subject>pacing and electrophysiology</subject><subject>Parenteral nutrition</subject><subject>Patients</subject><subject>Stroke</subject><subject>Stroke - diagnosis</subject><subject>Tomography, X-Ray Computed</subject><subject>Ultrasonic imaging</subject><issn>1757-790X</issn><issn>1757-790X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkc1Lw0AQxRdRbKk9e5OCF1Fi9zO7uQgifkHBi4K3ZTbZtClptu4mgv-9aVNrFQTnssPObx7zeAgdE3xJCIvHJvURxSSJKKMCqz3UJ1LISCb4dX-n76FhCHPcFiNccXaIeozRRHHJ-uh6YvN6BLUvXORscMsZTC2Uo7wIdVPCCPLa-vV8_Wl8UZZQF64agemaI3SQQxnscPMO0Mvd7fPNQzR5un-8uZ5EhvO4jhIjJBcqTjOaAOSYp1lCISaSM5sqA4JxDJxYa6ylSmLOuJJKZJkEyeLMsAG66nSXjVnYLLVV7aHUS18swH9oB4X-OamKmZ66dy0lY1iJVuBsI-DdW2NDrRdFSG3rp7KuCZryOMGJoAS36OkvdO4aX7X2VpQSnEm6Ehx3VOpdCN7m22MI1quEdJuQXiWku4TajZNdD1v-K48WOO8As5j_Q-3iG94e-Bf9CVCGpwE</recordid><startdate>20201209</startdate><enddate>20201209</enddate><creator>Paul, Vishesh</creator><creator>Meenakshisundaram, Rajamurugan</creator><creator>Jamal, Abdur R</creator><creator>Bin Farooq, Talha</creator><general>BMJ Publishing Group Ltd</general><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-9266-4212</orcidid></search><sort><creationdate>20201209</creationdate><title>Left atrio-oesophageal fistula after atrial fibrillation ablation</title><author>Paul, Vishesh ; Meenakshisundaram, Rajamurugan ; Jamal, Abdur R ; Bin Farooq, Talha</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b446t-9b574586cd29aaf04cd92a61743ec8ba5340a41eebee28704348785dd7a736db3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Ablation</topic><topic>adult intensive care</topic><topic>Aged</topic><topic>Antibiotics</topic><topic>Atrial Fibrillation - therapy</topic><topic>Brain research</topic><topic>Cardiac arrhythmia</topic><topic>Case Report</topic><topic>Case reports</topic><topic>Catheter Ablation - adverse effects</topic><topic>Catheters</topic><topic>Emergency medical care</topic><topic>Endoscopy</topic><topic>Esophageal Fistula - diagnosis</topic><topic>Esophageal Fistula - etiology</topic><topic>Female</topic><topic>Fever</topic><topic>Fistula</topic><topic>Fistula - diagnosis</topic><topic>Fistula - etiology</topic><topic>Heart Atria</topic><topic>Heart Diseases - diagnosis</topic><topic>Heart Diseases - etiology</topic><topic>Humans</topic><topic>Injuries</topic><topic>Magnetic Resonance Imaging</topic><topic>Mortality</topic><topic>Ostomy</topic><topic>pacing and electrophysiology</topic><topic>Parenteral nutrition</topic><topic>Patients</topic><topic>Stroke</topic><topic>Stroke - diagnosis</topic><topic>Tomography, X-Ray Computed</topic><topic>Ultrasonic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Paul, Vishesh</creatorcontrib><creatorcontrib>Meenakshisundaram, Rajamurugan</creatorcontrib><creatorcontrib>Jamal, Abdur R</creatorcontrib><creatorcontrib>Bin Farooq, Talha</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ case reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Paul, Vishesh</au><au>Meenakshisundaram, Rajamurugan</au><au>Jamal, Abdur R</au><au>Bin Farooq, Talha</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Left atrio-oesophageal fistula after atrial fibrillation ablation</atitle><jtitle>BMJ case reports</jtitle><stitle>BMJ Case Rep</stitle><addtitle>BMJ Case Rep</addtitle><date>2020-12-09</date><risdate>2020</risdate><volume>13</volume><issue>12</issue><spage>e232508</spage><pages>e232508-</pages><issn>1757-790X</issn><eissn>1757-790X</eissn><abstract>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.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd</pub><pmid>33298473</pmid><doi>10.1136/bcr-2019-232508</doi><orcidid>https://orcid.org/0000-0002-9266-4212</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Ablation adult intensive care Aged Antibiotics Atrial Fibrillation - therapy Brain research Cardiac arrhythmia Case Report Case reports Catheter Ablation - adverse effects Catheters Emergency medical care Endoscopy Esophageal Fistula - diagnosis Esophageal Fistula - etiology Female Fever Fistula Fistula - diagnosis Fistula - etiology Heart Atria Heart Diseases - diagnosis Heart Diseases - etiology Humans Injuries Magnetic Resonance Imaging Mortality Ostomy pacing and electrophysiology Parenteral nutrition Patients Stroke Stroke - diagnosis Tomography, X-Ray Computed Ultrasonic imaging |
| title | Left atrio-oesophageal fistula after atrial fibrillation ablation |
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