Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Pericardial-esophageal Fistula Complicating Atrial Fibrillation Ablation Successfully Resolved after Pericardial Drainage with Conservative Management

  • Seo, Jeong-Min (Department of Cardiology, Cardio-Cerebrovascular Center, Dong-A University Hospital) ;
  • Park, Jong Sung (Department of Cardiology, Cardio-Cerebrovascular Center, Dong-A University Hospital) ;
  • Jeong, Sang-Seok (Department of Thoracic Surgery, Cardio-Cerebrovascular Center, Dong-A University Hospital)
  • Received : 2016.10.31
  • Accepted : 2017.08.10
  • Published : 2017.11.30
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Abstract

A 40-year-old male patient underwent radiofrequency catheter ablation for symptomatic paroxysmal atrial fibrillation (AF). Although pulmonary vein (PV) isolation was successfully completed without acute complications, the patient began complaining of sustained retrosternal pain. Seventeen days after ablation, the patient visited the emergency room with fever and severe chest pain with pericarditis-like features. Chest computed tomography (CT) revealed clustered air bubbles in the pericardial space. Esophagography confirmed leakage of contrast agent into the pericardial space but not into the left atrium. While performing pericardiostomy, the operator confirmed the absence of active bleeding from the left atrium. Because there were no signs of left atrial-esophageal fistula, such as systemic embolization, conservative management based on strict fasting with fluids and antibiotic therapy was undertaken. Follow-up esophagography performed 2 weeks later showed no more contrast agent leakage, and the patient was discharged without further incident.

Keywords

References

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  3. Surgical and endoscopic management of a pericardioesophageal fistula after radiofrequency pulmonary vein isolation vol.43, pp.11, 2017, https://doi.org/10.1111/pace.13988
  4. Esophago-Pericardial Fistulae as a Sequela of Boerhaave Syndrome and Esophageal Stenting: A Case Report and Review of Literature vol.9, pp.None, 2017, https://doi.org/10.1177/23247096211036540