title: [Atrio-oesophageal fistula after thoracoscopic treatment of atrial fibrillation].
abstract: An atrio-oesophageal fistula (AOF) is a rare but severe complication of radiofrequency ablation during video-assisted thoracoscopic pulmonary vein isolation (VATS-PVI).
  
  
  
  A 68-year-old man presented to the emergency department with reduced general well-being and a fever. Eight weeks prior he had undergone a VATS-PVI. Blood results revealed elevated inflammatory parameters, and blood cultures were positive for Streptococcus anginosus. A CT-scan demonstrated an air configuration in the left atrium. Shortly after this he developed a left-sided hemiparesis. As a cerebral air embolus due to an AOF was suspected, we decided to operate. The defects in the atrium and the oesophagus were closed primarily during open-heart surgery.
  
  
  
  An AOF is a rare complication following a VATS-PVI. Patients often present with non-specific symptoms like a fever. It is important to be alert of this complication after a VATS-PVI and to perform early diagnostic imaging.
authors.affiliation: Erasmus MC, Rotterdam.
authors.forename: L J X
authors.initials: LJ
authors.lastname: Giesen
authors.forename: H M
authors.initials: HM
authors.lastname: Kroon
authors.forename: R
authors.initials: R
authors.lastname: van Valen
authors.forename: N M S
authors.initials: NM
authors.lastname: de Groot
authors.forename: C
authors.initials: C
authors.lastname: Kik
authors.forename: B P L
authors.initials: BP
authors.lastname: Wijnhoven
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D009202:Cardiomyopathies / Q000175:diagnosis / Q000209:etiology*; D017115:Catheter Ablation / Q000009:adverse effects*; D004937:Esophageal Fistula / Q000175:diagnosis / Q000209:etiology*; D005402:Fistula / Q000175:diagnosis / Q000209:etiology*; D006325:Heart Atria; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D011667:Pulmonary Veins / Q000601:surgery; D013906:Thoracoscopy / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed / Q000009:adverse effects