Subarachnoid hemorrhage as the initial imaging finding of atrial-esophageal Fistula: a case report highlighting diagnostic challenges
Atrial-esophageal fistula (AEF) is a rare but life-threatening complication after catheter ablation. Neurological deficits represent the second most common clinical manifestation associated with AEF; however, diagnosis is often delayed because initial symptoms can be atypical and easily overlooked....
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1594763/full |
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| author | Siwei Chen Wei Sun Yongan Sun Lanqiu Yao Qing Peng |
| author_facet | Siwei Chen Wei Sun Yongan Sun Lanqiu Yao Qing Peng |
| author_sort | Siwei Chen |
| collection | DOAJ |
| description | Atrial-esophageal fistula (AEF) is a rare but life-threatening complication after catheter ablation. Neurological deficits represent the second most common clinical manifestation associated with AEF; however, diagnosis is often delayed because initial symptoms can be atypical and easily overlooked. Here we reported a case involving a 51-year-old male who presented with fever and headache three weeks after catheter ablation for atrial fibrillation. Initial cranial computed tomography (CT) showed right frontal subarachnoid hemorrhage (SAH) without aneurysm. As the patient's condition deteriorates, repeated imaging demonstrates worsening SAH, cerebral air emboli, and air signals in the left atrium. This case highlights the importance of considering AEF in patients with neurological deficits and recent cardiac ablation, even when initial imaging findings are atypical. |
| format | Article |
| id | doaj-art-d99019bf19674fadb54c1bc13628a92e |
| institution | DOAJ |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-d99019bf19674fadb54c1bc13628a92e2025-08-20T03:12:09ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-07-011210.3389/fcvm.2025.15947631594763Subarachnoid hemorrhage as the initial imaging finding of atrial-esophageal Fistula: a case report highlighting diagnostic challengesSiwei Chen0Wei Sun1Yongan Sun2Lanqiu Yao3Qing Peng4Department of Neurology, Peking University First Hospital, Beijing, ChinaDepartment of Neurology, Peking University First Hospital, Beijing, ChinaDepartment of Neurology, Peking University First Hospital, Beijing, ChinaDepartment of Population Health, School of Medicine, New York University, New York, NY, United StatesDepartment of Neurology, Peking University First Hospital, Beijing, ChinaAtrial-esophageal fistula (AEF) is a rare but life-threatening complication after catheter ablation. Neurological deficits represent the second most common clinical manifestation associated with AEF; however, diagnosis is often delayed because initial symptoms can be atypical and easily overlooked. Here we reported a case involving a 51-year-old male who presented with fever and headache three weeks after catheter ablation for atrial fibrillation. Initial cranial computed tomography (CT) showed right frontal subarachnoid hemorrhage (SAH) without aneurysm. As the patient's condition deteriorates, repeated imaging demonstrates worsening SAH, cerebral air emboli, and air signals in the left atrium. This case highlights the importance of considering AEF in patients with neurological deficits and recent cardiac ablation, even when initial imaging findings are atypical.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1594763/fullatrial-esophageal fistulasubarachnoid hemorrhagecatheter ablation complicationsdelayed diagnosiscerebral air embolism |
| spellingShingle | Siwei Chen Wei Sun Yongan Sun Lanqiu Yao Qing Peng Subarachnoid hemorrhage as the initial imaging finding of atrial-esophageal Fistula: a case report highlighting diagnostic challenges Frontiers in Cardiovascular Medicine atrial-esophageal fistula subarachnoid hemorrhage catheter ablation complications delayed diagnosis cerebral air embolism |
| title | Subarachnoid hemorrhage as the initial imaging finding of atrial-esophageal Fistula: a case report highlighting diagnostic challenges |
| title_full | Subarachnoid hemorrhage as the initial imaging finding of atrial-esophageal Fistula: a case report highlighting diagnostic challenges |
| title_fullStr | Subarachnoid hemorrhage as the initial imaging finding of atrial-esophageal Fistula: a case report highlighting diagnostic challenges |
| title_full_unstemmed | Subarachnoid hemorrhage as the initial imaging finding of atrial-esophageal Fistula: a case report highlighting diagnostic challenges |
| title_short | Subarachnoid hemorrhage as the initial imaging finding of atrial-esophageal Fistula: a case report highlighting diagnostic challenges |
| title_sort | subarachnoid hemorrhage as the initial imaging finding of atrial esophageal fistula a case report highlighting diagnostic challenges |
| topic | atrial-esophageal fistula subarachnoid hemorrhage catheter ablation complications delayed diagnosis cerebral air embolism |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1594763/full |
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