Jones Sarah, Kara Areeba
Sarah Jones and Areeba Kara are hospitalists at Indiana University Health Methodist Hospital in Indianapolis, Ind. The authors have disclosed no potential conflicts of interest, financial or otherwise.
JAAPA. 2022 Jun 1;35(6):28-33. doi: 10.1097/01.JAA.0000819572.85440.3c.
Atrioesophageal fistula with resulting air emboli is a rare but potentially fatal complication of radiofrequency catheter ablation (RFCA) for atrial fibrillation. Patients typically present within 60 days after RFCA with fever, neurologic deficits, chest pain, and gastrointestinal bleeding. Chest CT with IV contrast reveals the atrioesophageal fistula in most cases, and CT of the head or MRI of the brain commonly reveals signs of air emboli. Early diagnosis, initiation of antibiotics, and immediate surgical intervention may improve patients' chances of survival.
射频导管消融术(RFCA)治疗心房颤动导致的心房食管瘘并伴有空气栓塞是一种罕见但可能致命的并发症。患者通常在RFCA术后60天内出现发热、神经功能缺损、胸痛和胃肠道出血等症状。多数情况下,静脉注射造影剂后的胸部CT可显示心房食管瘘,头部CT或脑部MRI通常可显示空气栓塞的迹象。早期诊断、使用抗生素及立即进行手术干预可能会提高患者的生存几率。