The undesirable communication: A case of cerebral air emboli in the setting of atrio- esophageal fistula following atrial fibrillation catheter ablation


  • Momin Islam Houston Methodist Hospital, Department of Cardiology; USA
  • Hussam Al Hennawi Department of Internal Medicine, Jefferson Abington Hospital, Abington, PA, USA
  • Anwar Khedr Department of Internal Medicine, BronxCare Health System, NY, USA
  • Khaled Harmouch University of Nebraska Medical Center, Omaha, Nebraska; USA
  • Mohammad F Mathbout Medical University of South Carolina, Department of Cardiology; Charleston, South Carolina; USA.



Atrial-esophageal fistula is an extremely rare condition but is often a deleterious complication following catheter ablation for atrial fibrillation. The associated iatrogenic communication acts as a conduit for air and bacterial translocation, which may lead to cerebral air embolism and polymicrobial sepsis, respectively. Coupled with a history of invasive procedures, the diagnosis is largely based on the accompanying neurological symptoms. In this report, we present the case of a 73-year-old female who presented with neurological deficits attributed to cerebral vascular emboli three weeks after catheter ablation for the treatment of chronic atrial fibrillation.






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