Survival of a Patient with an Esophagopericardial Fistula After Catheter Ablation for Atrial Fibrillation: A Case Report and Literature Review

Veseli, Granit; Iwai, Sei; Jacobson, Jason T.

doi:10.19102/icrm.2020.110503

Cited by 3 publications

(8 citation statements)

References 32 publications

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“…The incidence of esophagopericardial fistula (EPF) ranges is 0.016–0.04% [ 3 , 6 ]. It has protean clinical presentations, but chest pain with/without fever is common [ 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…Veseli et al presented a case of a 59-year-old man with persistent atrial fibrillation who was admitted to another hospital with severe chest pain radiating to the back, 24 days after undergoing pulmonary vein isolation. An initial chest tomography scan ruled out aortic dissection, but echocardiography revealed a small amount of pericardial fluid [ 3 ]. The patient’s hospital course became worse and he even required mechanical circulatory support (extracorporeal membrane oxygenation (ECMO) and intra-aortic balloon pump [IABP]) [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…An initial chest tomography scan ruled out aortic dissection, but echocardiography revealed a small amount of pericardial fluid [ 3 ]. The patient’s hospital course became worse and he even required mechanical circulatory support (extracorporeal membrane oxygenation (ECMO) and intra-aortic balloon pump [IABP]) [ 3 ]. The patient was discharged to a rehabilitation center after 50 days, while ours was discharged home after 7 days [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…The patient’s hospital course became worse and he even required mechanical circulatory support (extracorporeal membrane oxygenation (ECMO) and intra-aortic balloon pump [IABP]) [ 3 ]. The patient was discharged to a rehabilitation center after 50 days, while ours was discharged home after 7 days [ 3 ]. Although symptoms can present in ≤2 months, there should be a high index of suspicion for esophageal rupture and EPF in patients with similar presentations between 3–35 days after RFA [ 6 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Its presentation varies and can include chest pain, dysphagia, fever, nausea, vomiting, and hematemesis. Only a few cases of this unusual defect have been reported in the literature [ 3 – 5 ]. We report a case of EPF and pneumopericardium as a complication of pulmonary vein isolation in a 62-year-old man with AF.…”

Section: Introductionmentioning

confidence: 99%

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Esophagopericardial Fistula and Pneumopericardium as a Complication of Pulmonary Vein Isolation in a 62-Year-Old Man with Atrial Fibrillation: A Case Report

et al. 2022

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Patient: Male, 62-year-old Final Diagnosis: Pneumopericardium Symptoms: Chest pain Medication: — Clinical Procedure: — Specialty: Cardiology Objective: Rare disease Background: Pulmonary vein isolation is a method of cardiac ablation therapy used to treat irregular heart rhythm, including atrial fibrillation (AF). This report presents a case of esophagopericardial fistula (EPF) and pneumopericardium as a complication of pulmonary vein isolation in a 62-year-old man with AF. Case Report: We report the rare case of a 62-year-old man with a medical history of persistent atrial fibrillation status after ablation 3 days prior to his initial Emergency Department visit for chest pain. Acute coronary syndrome was ruled out with normal electrocardiogram, echocardiography, and troponin tests. Fluid overload and sotalol adverse effects were presumed to be the cause of his symptoms. We discontinued sotalol with diuresis and he was discharged home when his chest pain subsided. Nine days later, he returned to the Emergency Department with worsening similar symptoms and was eventually diagnosed with EPF and pneumopericardium on a computed tomography scan of the chest with contrast. He was managed with esophagogastroduodenoscopy and stent placement along with subxiphoid pericardial window and pericardial drain placement. The patient was discharged in stable condition after removing the pericardial drain. At 10-day and 1-month follow-up, he had no recurrent symptoms. Conclusions: This report shows that although EPF with pneumopericardium is a rare complication of pulmonary vein isolation, it should be rapidly diagnosed and treated as a life-threatening emergency.

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“…The incidence of esophagopericardial fistula (EPF) ranges is 0.016–0.04% [ 3 , 6 ]. It has protean clinical presentations, but chest pain with/without fever is common [ 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Esophagopericardial Fistula and Pneumopericardium as a Complication of Pulmonary Vein Isolation in a 62-Year-Old Man with Atrial Fibrillation: A Case Report

et al. 2022

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Esophageal pericardial fistula caused by esophageal carcinoma: a case report and literature review

Wang,

Fan,

et al. 2024

Preprint

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Esophago-pericardial fistula is a rare disease, and reports about it are rare. But esophagopericardial fistula is a serious condition with rapid progression, easy to miss diagnosis and misdiagnosis, and high fatality rate. However, there are no guidelines for its diagnosis and treatment in academia. This paper describes and analyzes a typical case of esophageal cancer-induced esophageal pericardial fistula, and summarizes the etiology, clinical manifestations, diagnosis, treatment, and prognosis of this disease in combination with previous literature on esophageal pericardial fistula, so as to further improve the understanding of esophageal pericardial fistula and esophageal tumors.

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A Case of Pericardial Perforation of an Esophageal Ulcer Treated by Percutaneous Pericardial Drainage

Sakuraba,

Koizumi,

Ueda

et al. 2022

JJCS

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The patient was a 73-year-old woman with Parkinsonʼs disease, for which she was receiving medical treatment. She was referred to our hospital with a 2-day history of fever and dyspnea. The patient was diagnosed as having an esophageal ulcer with pericardial perforation, based on the findings of chest and abdominal contrast-enhanced CT and upper gastrointestinal endoscopy. Both surgical treatment under general anesthesia and percutaneous pericardial drainage were considered, but due to the patientʼs poor nutritional status, percutaneous drainage was performed. After drainage, antibiotic therapy, and enteral feeding, the inflammatory response improved and the fistula closed, and the patient was transferred to another hospital on day 54. The patient had no risk factors for an esophageal ulcer, such as a history of gastrointestinal surgery or radiation therapy, or medication, and no obvious precipitating factors could be identified.

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Survival of a Patient with an Esophagopericardial Fistula After Catheter Ablation for Atrial Fibrillation: A Case Report and Literature Review

Cited by 3 publications

References 32 publications

Esophagopericardial Fistula and Pneumopericardium as a Complication of Pulmonary Vein Isolation in a 62-Year-Old Man with Atrial Fibrillation: A Case Report

Esophagopericardial Fistula and Pneumopericardium as a Complication of Pulmonary Vein Isolation in a 62-Year-Old Man with Atrial Fibrillation: A Case Report

Esophageal pericardial fistula caused by esophageal carcinoma: a case report and literature review

A Case of Pericardial Perforation of an Esophageal Ulcer Treated by Percutaneous Pericardial Drainage

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