CTICasesAtrioesophageal Fistula Post-Ablation
Imaging findings
Chest CT shows a large gas and fluid-filled structure in the left atrium directly adjacent to the esophagus. Transseptal puncture tract is visible. Esophagram did not show contrast leakage. The patient presented with endocarditis and embolic strokes six months after left atrial ablation.
Key takeaways
Atrioesophageal fistula is a rare but highly lethal complication of catheter ablation for atrial fibrillation. Although typically presenting within weeks, it can have a delayed presentation months after the procedure, presenting with embolic strokes or hematemesis.
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