Successful non-operative management of left atrioesophageal fistula following catheter ablation

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• 作者：Manabu Shiraishi (1)
  Hideki Morita (1)
  Kenichi Muramatsu (2)
  Akira Sato (2)
  Junichi Nitta (2)
  Atsushi Yamaguchi (3)
  Hideo Adachi (3)
  
• 关键词：Atrioesophageal fistula ; Catheter ablation ; Radiofrequency ablation
• 刊名：Surgery Today
• 出版年：2014
• 出版时间：August 2014
• 年：2014
• 卷：44
• 期：8
• 页码：1565-1568
• 全文大小：343 KB
• 参考文献：1. Khandhar S, Nitzschke S, Ad N. Left atrioesophageal fistula following catheter ablation for atrial fibrillation: off-bypass, primary repair using an extrapericardial approach. J Thorac Cardiovasc Surg. 2010;139:507-. CrossRef
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• 作者单位：Manabu Shiraishi (1)
  Hideki Morita (1)
  Kenichi Muramatsu (2)
  Akira Sato (2)
  Junichi Nitta (2)
  Atsushi Yamaguchi (3)
  Hideo Adachi (3)
  
  1. Division of Cardiovascular Surgery, Saitama Red-cross Hospital, 8-3-33 Kamiochiai, Chyuo-ku, Saitama, Saitama, 338-8553, Japan
  2. Division of Cardiovascular Internal Medicine, Saitama Red-cross Hospital, Saitama, Japan
  3. Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
  
• ISSN：1436-2813

文摘

Atrioesophageal fistula (AEF) is a potentially lethal complication of catheter radiofrequency ablation for atrial fibrillation. A 49-year-old man with paroxysmal atrial fibrillation who underwent catheter ablation around the pulmonary vein was admitted 31?days after the procedure, suffering seizures and fever. Magnetic resonance imaging of the brain showed ischemia and multiple lesions of acute infarction in the right occipital lobe of the cerebrum. Computed tomography (CT) of the chest showed a small accumulation of air between the posterior left atrium and the esophagus, suggesting an AEF. Endoscopic snaring of the esophageal mucosa, repeated a few times, supported by nil by mouth and antibiotic therapy, resulted in improvement of his condition with no recurrence of symptoms. Subsequent chest CT scans confirmed disappearance of the leaked air and the patient was discharged home 45?days after admission with no neurological compromise.