心房颤动消融术后因心房-食管瘘导致的出血性脑空气栓塞

Haemorrhagic cerebral air embolism from an atrio-oesophageal fistula following atrial fibrillation ablation.

作者信息

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

机构信息

Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK.

Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK

出版信息

Perfusion. 2015 Sep;30(6):484-6. doi: 10.1177/0267659114562102. Epub 2014 Dec 4.

DOI:10.1177/0267659114562102

PMID:25475690

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.

摘要

我们报告了一例心房颤动（AF）消融术后三周被发现昏迷的男性病例。头颅和胸部影像学检查显示，继发于心房食管瘘（AEF）的多处肺栓塞梗死灶。AEF是AF消融术一种已被认知但罕见的并发症。（1 - 8）由于不进行手术干预死亡率为100%，早期识别至关重要。我们探讨了AEF形成的推测机制、临床表现范围、检查及治疗方法。