Key result
Massive air embolism, especially when multifocal, should raise suspicion for atrioesophageal fistula following recent ablation for atrial fibrillation.
Case Report
Multifocal massive air embolism after recent atrial fibrillation ablation is a critical warning sign for atrioesophageal fistula, which can occur despite adherence to power limits on the posterior wall.
Multifocal air embolism warrants AEF evaluation after AF ablation despite limited posterior power; case report extends alerts but leaves open generalizability.
Key Teaching Points•Massive air embolism, especially when multifocal, should raise suspicion for atrioesophageal fistula (AEF) at the first medical contact. History of recent ablation for atrial fibrillation should be actively sought.•AEF might occur even after procedures in which power applied to the posterior left atrial wall is limited, in accordance with current recommendations.•Left atrial thrombosis at or close to the presumed location of the AEF could also occur. •Massive air embolism, especially when multifocal, should raise suspicion for atrioesophageal fistula (AEF) at the first medical contact. History of recent ablation for atrial fibrillation should be actively sought.•AEF might occur even after procedures in which power applied to the posterior left atrial wall is limited, in accordance with current recommendations.•Left atrial thrombosis at or close to the presumed location of the AEF could also occur.
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Traykov et al. (2018) conducted a case report in Atrial fibrillation, atrioesophageal fistula, massive air embolism. Ablation for atrial fibrillation was evaluated. Massive air embolism, especially when multifocal, should raise suspicion for atrioesophageal fistula following recent ablation for atrial fibrillation.
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