Wu Po-Sheng, Liu Jui-Chen, Chen Chun-Hung
China Medical University Hospital Emergency Department Taichung Taiwan.
Buddhist Dalin Tzu Chi General Hospital Neurology Chiayi County Taiwan.
J Acute Med. 2024 Dec 1;14(4):160-163. doi: 10.6705/j.jacme.202412_14(4).0004.
We report a case highlighting the global prevalence of atrial fibrillation (Afib) and the increased use of ablation therapy, underscoring the importance of understanding its complications, especially atrio-esophageal fistula (AEF), a rare but potentially fatal outcome. This case involves a 38-year-old male who underwent radiofrequency ablation for Afib and was subsequently hospitalized with abrupt left-sided weakness. Initially presumed to be a transient ischemic attack (TIA), his condition progressed to seizures and reduced consciousness. The computed tomography scans revealed pneumocranium, leading to a diagnosis of AEF. Despite the rapid identification of this complication, the patient's condition deteriorated quickly, resulting in his death on the 10th day. This case exemplifies that while AEF is an infrequent complication (0.1%-0.2%) following Afib ablation, it is of critical concern. The initial symptoms of AEF can be misleading, which accentuates the necessity for prompt recognition and timely intervention. Employing appropriate diagnostic techniques and ablation strategies are crucial to enhance patient outcomes and reduce the risks associated with AEF.
我们报告了一例病例，突出显示了心房颤动（房颤）的全球患病率以及消融治疗使用的增加，强调了了解其并发症的重要性，尤其是心房食管瘘（AEF），这是一种罕见但可能致命的结果。该病例涉及一名38岁男性，他接受了房颤射频消融术，随后因突然出现左侧肢体无力而住院。最初被认为是短暂性脑缺血发作（TIA），其病情进展为癫痫发作和意识减退。计算机断层扫描显示有颅内积气，从而诊断为AEF。尽管迅速识别出了这一并发症，但患者的病情迅速恶化，最终在第10天死亡。该病例表明，虽然AEF是房颤消融术后一种罕见的并发症（0.1%-0.2%），但却是至关重要的关注点。AEF的初始症状可能具有误导性，这凸显了及时识别和及时干预的必要性。采用适当的诊断技术和消融策略对于改善患者预后以及降低与AEF相关的风险至关重要。
