Key result
Esophagogastroduodenoscopy in a man with suspected atrioesophageal fistula precipitated an embolic stroke, highlighting that endoscopy should be avoided when AEF is suspected.
Why the study?
Does esophagogastroduodenoscopy precipitate embolic stroke in patients with suspected atrioesophageal fistula?
Case Report (n=1)
Does esophagogastroduodenoscopy precipitate embolic stroke in patients with suspected atrioesophageal fistula?
Esophagogastroduodenoscopy should be avoided in patients with suspected atrioesophageal fistula following AF ablation due to the high risk of precipitating embolic stroke.
Endoscopy risks stroke in suspected AEF post-AF ablation; this case leaves open prospective validation of diagnostic alternatives.
Atrioesophageal fistula (AEF) is a rare complication of atrial fibrillation ablation. We present a man with sepsis and frank hematemesis 3 weeks after atrial fibrillation ablation. Thoracic computed tomography showed no definitive evidence of AEF. He underwent esophagogastroduodenoscopy and subsequently developed an embolic stroke. In the operating room, he was found to have AEF. This case highlights the importance of maintaining a high index of suspicion for AEF because of its nonspecific presentation and difficulty in diagnosing with imaging or endoscopy. Once AEF is suspected, esophagogastroduodenoscopy should be avoided because of the risk of precipitating embolic events.
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Thapa et al. (2019) conducted a case report in Suspected atrioesophageal fistula after atrial fibrillation ablation (n=1). Esophagogastroduodenoscopy was evaluated on Embolic stroke. Esophagogastroduodenoscopy in a man with suspected atrioesophageal fistula precipitated an embolic stroke, highlighting that endoscopy should be avoided when AEF is suspected.
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