Shaohui Wu, Guangchen Zou, Yuzhang Sun, Weifeng Jiang, Xu Liu
{"title":"心房颤动导管消融术后的食道心包瘘:病例报告","authors":"Shaohui Wu, Guangchen Zou, Yuzhang Sun, Weifeng Jiang, Xu Liu","doi":"10.1093/ehjcr/ytae287","DOIUrl":null,"url":null,"abstract":"\n \n \n Oesophageal fistula is a rare complication of catheter ablation of atrial fibrillation with most fistulas being atrio-oesophageal fistulas, but oesophageal-pericardial fistula can also happen in the absence of atrial perforation.\n \n \n \n A 68-year-old male patient presented with chest pain 10 days after catheter ablation of paroxysmal atrial fibrillation. He was discharged after an initial negative workup which included a CT chest without contrast. He later presented again with severe chest pain and fever and was found to have a oesophageal-pericardial fistula. He underwent surgical and endoscopic treatment with good recovery.\n \n \n \n Patients with oesophago-pericardial fistulas often have delayed presentation 1-4 weeks after the ablation procedure. Early diagnosis can be challenging. CT with oral and intravenous contrast is often used for diagnosis. Treatment often includes antibiotics, surgical or interventional drainage of infected spaces with oesophageal repair, clipping or stenting. In contrast to atrio-oesophageal fistulas which carry a high mortality rate, mortality for oesophago-pericardial fistulas appears to be much lower.\n","PeriodicalId":507701,"journal":{"name":"European Heart Journal - Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Oesophago-pericardial fistula after catheter ablation of atrial fibrillation: a case report\",\"authors\":\"Shaohui Wu, Guangchen Zou, Yuzhang Sun, Weifeng Jiang, Xu Liu\",\"doi\":\"10.1093/ehjcr/ytae287\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"\\n \\n \\n Oesophageal fistula is a rare complication of catheter ablation of atrial fibrillation with most fistulas being atrio-oesophageal fistulas, but oesophageal-pericardial fistula can also happen in the absence of atrial perforation.\\n \\n \\n \\n A 68-year-old male patient presented with chest pain 10 days after catheter ablation of paroxysmal atrial fibrillation. He was discharged after an initial negative workup which included a CT chest without contrast. He later presented again with severe chest pain and fever and was found to have a oesophageal-pericardial fistula. He underwent surgical and endoscopic treatment with good recovery.\\n \\n \\n \\n Patients with oesophago-pericardial fistulas often have delayed presentation 1-4 weeks after the ablation procedure. Early diagnosis can be challenging. CT with oral and intravenous contrast is often used for diagnosis. Treatment often includes antibiotics, surgical or interventional drainage of infected spaces with oesophageal repair, clipping or stenting. In contrast to atrio-oesophageal fistulas which carry a high mortality rate, mortality for oesophago-pericardial fistulas appears to be much lower.\\n\",\"PeriodicalId\":507701,\"journal\":{\"name\":\"European Heart Journal - Case Reports\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-06-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Heart Journal - Case Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1093/ehjcr/ytae287\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Heart Journal - Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/ehjcr/ytae287","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Oesophago-pericardial fistula after catheter ablation of atrial fibrillation: a case report
Oesophageal fistula is a rare complication of catheter ablation of atrial fibrillation with most fistulas being atrio-oesophageal fistulas, but oesophageal-pericardial fistula can also happen in the absence of atrial perforation.
A 68-year-old male patient presented with chest pain 10 days after catheter ablation of paroxysmal atrial fibrillation. He was discharged after an initial negative workup which included a CT chest without contrast. He later presented again with severe chest pain and fever and was found to have a oesophageal-pericardial fistula. He underwent surgical and endoscopic treatment with good recovery.
Patients with oesophago-pericardial fistulas often have delayed presentation 1-4 weeks after the ablation procedure. Early diagnosis can be challenging. CT with oral and intravenous contrast is often used for diagnosis. Treatment often includes antibiotics, surgical or interventional drainage of infected spaces with oesophageal repair, clipping or stenting. In contrast to atrio-oesophageal fistulas which carry a high mortality rate, mortality for oesophago-pericardial fistulas appears to be much lower.