Esophageal cancer presenting with atrial fibrillation: a case report.
BACKGROUND
Atrial fibrillation was previously reported in patients with esophageal cancer as a complication of total esophagectomy or photodynamic therapy. Here, we propose that atrial fibrillation may also be caused by external compression of the left atrium by esophageal cancer.


METHODS
We present a 58-year-old man who developed atrial fibrillation with rapid ventricular rate in the emergency room while being evaluated for dysphagia and weight loss. Atrial fibrillation lasted less than 12 hours and did not recur. Echocardiogram did not reveal any structural heart disease. A 10-cm, ulcerated mid-esophageal mass was seen during esophagogastroscopy. Microscopic examination showed squamous cell carcinoma. Computed tomography of the chest revealed esophageal thickening compressing the left atrium.


CONCLUSIONS
External compression of the left atrium was previously reported to provoke atrial fibrillation. Similarly, esophageal cancer may precipitate atrial fibrillation by mechanical compression of the left atrium or pulmonary veins, triggering ectopic beats in susceptible patients.
Bayraktar
Ulas Darda
UD
Division of Hematology and Oncology, Sylvester Comprehensive Cancer Center, Miami, FL, USA. ubayraktar@med.miami.edu
Dufresne
Alix
A
Bayraktar
Soley
S
Purcell
Roland Royston
RR
Ajah
Ofem Ibiah
OI
Ann Thorac Surg. 1988 Feb;45(2):137-43
3277551
Am Heart J. 1994 Apr;127(4 Pt 1):950-1
8154443
N Engl J Med. 1982 Apr 29;306(17):1018-22
7062992
J Thorac Cardiovasc Surg. 2002 May;123(5):919-27
12019377
Circulation. 1999 Nov 2;100(18):1879-86
10545432
Heart Rhythm. 2006 Aug;3(8):971-4
16876749
Gastroenterology. 1972 Apr;62(4):632-5
5020876
Lasers Surg Med. 1997;21(4):317-20
9328978
BMC Ear Nose Throat Disord. 2006 Dec 13;6:15
17166260
Pacing Clin Electrophysiol. 1987 Jan;10(1 Pt 1):133-8
2436158
Echocardiography. 2004 Jan;21(1):61-4
14717723