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.

中文翻译：

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心房消融并发症中的栓塞性卒中和房食管瘘

目标

心房食管瘘（AEF）是心房消融手术中一种罕见但可能致命的并发症。我们介绍了一名患有心源性脑梗死和继发于房食管瘘的脓毒症的患者，该病可能是在房颤的心房消融手术后发生的。

案例展示

一名 66 岁的男子最初因腹泻和败血症被送往急诊室，但随后因发生多发性严重脑梗塞而病情复杂化。尽管高度怀疑脓毒性栓塞，但在诊断房食管瘘之前仍需要进行广泛的检查。

结论

尽管罕见，但心房食管瘘是常见心房消融手术的高死亡率并发症。需要高度怀疑才能及时诊断并开始适当的治疗。