Pus in the pericardium: a pericardial-oesophageal fistula with cardiac tamponade after ablation for atrial fibrillation
Background: Pericardial/atrial oesophageal fistula (PEF/AEF) is the most feared complication of cardiac atrial fibrillation (AF) ablation. Without urgent surgical treatment, most cases of this infrequent complication rapidly prove fatal. Case report: We present an uncommon case of a 60-year-old male...
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| Language: | English |
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SMC MEDIA SRL
2025-01-01
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| Series: | European Journal of Case Reports in Internal Medicine |
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| Online Access: | https://www.ejcrim.com/index.php/EJCRIM/article/view/5102 |
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| author | Taha Mansoor Nahal Massoudi Anandbir Bath Matthew Kelly Santhosh Koshy Armand Tanase |
| author_facet | Taha Mansoor Nahal Massoudi Anandbir Bath Matthew Kelly Santhosh Koshy Armand Tanase |
| author_sort | Taha Mansoor |
| collection | DOAJ |
| description | Background: Pericardial/atrial oesophageal fistula (PEF/AEF) is the most feared complication of cardiac atrial fibrillation (AF) ablation. Without urgent surgical treatment, most cases of this infrequent complication rapidly prove fatal.
Case report: We present an uncommon case of a 60-year-old male who had undergone an AF ablation 2 weeks prior and presented with chest pain. Following diagnosis and treatment of ST-elevation myocardial infarction (STEMI), a small pericardial effusion was noticed on computed tomography (CT) scan. Despite an initially reassuring hospital course, rapid decompensation and expansion of his purulent pericardial effusion led to his death within 24 hours of presentation. A post-mortem review of his CT imaging revealed an inconspicuous PEF.
Conclusions: It is essential to maintain a high suspicion of PEF/AEF in patients presenting after AF ablation with suggestive symptoms, such as fever, chest pain/odynophagia, and neurological deficits. CT chest is the most common diagnostic modality and surgical correction is the treatment of choice. |
| format | Article |
| id | doaj-art-e9c1aded322f4ea4a165d7617e913afe |
| institution | Kabale University |
| issn | 2284-2594 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | SMC MEDIA SRL |
| record_format | Article |
| series | European Journal of Case Reports in Internal Medicine |
| spelling | doaj-art-e9c1aded322f4ea4a165d7617e913afe2025-02-04T13:37:20ZengSMC MEDIA SRLEuropean Journal of Case Reports in Internal Medicine2284-25942025-01-0110.12890/2025_0051024637Pus in the pericardium: a pericardial-oesophageal fistula with cardiac tamponade after ablation for atrial fibrillationTaha Mansoor0Nahal Massoudi1Anandbir Bath2Matthew Kelly3Santhosh Koshy4Armand Tanase5Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, USAWestern Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, USAAscension Borgess Hospital, Kalamazoo, USAWestern Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, USAWestern Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, USA; Ascension Borgess Hospital, Kalamazoo, USAWestern Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, USA; Ascension Borgess Hospital, Kalamazoo, USABackground: Pericardial/atrial oesophageal fistula (PEF/AEF) is the most feared complication of cardiac atrial fibrillation (AF) ablation. Without urgent surgical treatment, most cases of this infrequent complication rapidly prove fatal. Case report: We present an uncommon case of a 60-year-old male who had undergone an AF ablation 2 weeks prior and presented with chest pain. Following diagnosis and treatment of ST-elevation myocardial infarction (STEMI), a small pericardial effusion was noticed on computed tomography (CT) scan. Despite an initially reassuring hospital course, rapid decompensation and expansion of his purulent pericardial effusion led to his death within 24 hours of presentation. A post-mortem review of his CT imaging revealed an inconspicuous PEF. Conclusions: It is essential to maintain a high suspicion of PEF/AEF in patients presenting after AF ablation with suggestive symptoms, such as fever, chest pain/odynophagia, and neurological deficits. CT chest is the most common diagnostic modality and surgical correction is the treatment of choice.https://www.ejcrim.com/index.php/EJCRIM/article/view/5102pericardial-oesophageal fistulaatrial-pericardial fistulaablationatrial fibrillation |
| spellingShingle | Taha Mansoor Nahal Massoudi Anandbir Bath Matthew Kelly Santhosh Koshy Armand Tanase Pus in the pericardium: a pericardial-oesophageal fistula with cardiac tamponade after ablation for atrial fibrillation European Journal of Case Reports in Internal Medicine pericardial-oesophageal fistula atrial-pericardial fistula ablation atrial fibrillation |
| title | Pus in the pericardium: a pericardial-oesophageal fistula with cardiac tamponade after ablation for atrial fibrillation |
| title_full | Pus in the pericardium: a pericardial-oesophageal fistula with cardiac tamponade after ablation for atrial fibrillation |
| title_fullStr | Pus in the pericardium: a pericardial-oesophageal fistula with cardiac tamponade after ablation for atrial fibrillation |
| title_full_unstemmed | Pus in the pericardium: a pericardial-oesophageal fistula with cardiac tamponade after ablation for atrial fibrillation |
| title_short | Pus in the pericardium: a pericardial-oesophageal fistula with cardiac tamponade after ablation for atrial fibrillation |
| title_sort | pus in the pericardium a pericardial oesophageal fistula with cardiac tamponade after ablation for atrial fibrillation |
| topic | pericardial-oesophageal fistula atrial-pericardial fistula ablation atrial fibrillation |
| url | https://www.ejcrim.com/index.php/EJCRIM/article/view/5102 |
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