Embolic stroke and atrioesophageal fistula as complications of atrial ablation.

OBJECTIVES

Atrioesophagel fistula (AEF) is a rare, but potentially deadly complication of atrial ablation procedures. We present a case of a patient with cardioembolic cerebral infarcts and sepsis secondary to an atrioesophageal fistula, which likely developed after an atrial ablation procedure for atrial fibrillation.

CASE PRESENTATION

A 66-year-old man initially presented to an emergency department with diarrhea and sepsis, but his subsequent course was complicated by development of multiple, major cerebral infarcts. Despite high suspicion of septic embolism, extensive workup was required before the diagnosis of an atrioesophageal fistula was made.

CONCLUSIONS

Though rare, atrioesophageal fistula represents a high mortality complication of common atrial ablation procedures. A high index of suspicion is needed for timely diagnosis and to initiate appropriate treatment.