Haemorrhagic cerebral air embolism from an atrio-oesophageal fistula following atrial fibrillation ablation. (September 2015)

• Record Type: Journal Article
• Authors: Koa-Wing, M; Jamil-Copley, S; Ariff, B; Kojodjojo, P; Lim, P B; Whinnett, Z; Rajakulendran, S; Malhotra, P; Lefroy, D; Peters, N S; Davies, D W; Kanagaratnam, P
• Is Part Of: Perfusion. Volume 30:Number 6(2015)
• Page Start: 484
• Page End: 486
• Publication Date: 2015-09
• Subjects: atrio-oesophageal fistula -- atrial fibrillation ablation; Perfusion (Physiology) -- Periodicals; Blood -- Circulation, Artificial -- Periodicals; Heart -- Surgery -- Periodicals; Extracorporeal Circulation -- Periodicals; Perfusion -- Periodicals; Circulation extracorporelle -- Périodiques; Perfusion -- Périodiques; 617.41
• DOI: 10.1177/0267659114562102
• Languages: English
• ISSNs: 0267-6591

Abstract

We report the case of a man found unconscious three weeks following atrial fibrillation (AF) ablation. Cranial and thoracic imaging demonstrated multiple areas of pneumo-embolic infarction secondary to an atrio-oesophageal fistula (AEF). AEF is a recognised, but rare, complication of AF ablation. 1–8 Early recognition is critical as the mortality is 100% without surgical intervention. We consider the postulated mechanisms of AEF formation, the spectrum of clinical presentation, investigations and treatment.