Key result
Pericardial fluid amylase may help differentiate pericardio-esophageal fistula from restricted perforation after AF ablation.
Why the study?
Esophageal injury following AF catheter ablation carries high mortality if unoperated, but definitive diagnosis by contrast chest CT is often delayed and may worsen outcomes.
Does pericardial fluid amylase detection aid in the early differential diagnosis of pericardio-esophageal fistula versus restricted esophageal perforation following atrial fibrillation ablation?
Case Report (n=1)
Does pericardial fluid amylase detection aid in the early differential diagnosis of pericardio-esophageal fistula versus restricted esophageal perforation following atrial fibrillation ablation?
Pericardial fluid amylase detection may offer a simple and early method to exclude lethal pericardio-esophageal fistula in patients presenting with pericardial effusion after AF ablation.
May prompt amylase testing in post-AF ablation effusions; leaves open prospective validation before clinical adoption.
Esophageal injury is a serious complication following atrial fibrillation catheter ablation procedures. It may manifest as atrio-esophageal fistula, pericardio-esophageal fistula (PEF), or restricted perforation, with high mortality rate if left unoperated. Chest computed tomography with intravenous contrast is the mainstay of diagnosis; however, a definite imaging diagnosis is often delayed and may worsen patient outcomes. This case demonstrates that pericardial fluid amylase detection may contribute to early differential diagnosis of PEF versus restricted esophageal perforation combined with inflammatory pericarditis, in patients with relevant symptoms who present with pericardial effusion and may guide either conservative-as our case-or surgical approach.
No takes yet. Share an insight, caveat, or question.
Leventopoulos et al. (2024) conducted a case report in Esophageal injury following atrial fibrillation radiofrequency ablation (n=1). Pericardial fluid amylase detection was evaluated on Early differential diagnosis of pericardio-esophageal fistula versus restricted esophageal perforation. Pericardial fluid amylase detection may contribute to early differential diagnosis of pericardio-esophageal fistula versus restricted esophageal perforation following atrial fibrillation ablation.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: