A case of a death caused by an atrial-oesophageal-thoracic fistula after radiofrequency ablation of atrial fibrillation

作者全名："Wu, Qi-Long; Wang, Qi; Guo, Gao-Xian; Li, Yong-Guo; Xing, Yu; Zhao, Min-Zhu; Li, Hongwei; Li, Jian-Bo"

作者地址："[Wu, Qi-Long; Wang, Qi; Guo, Gao-Xian; Li, Yong-Guo; Xing, Yu; Zhao, Min-Zhu; Li, Jian-Bo] Chongqing Med Univ, Fac Basic Med Sci, Dept Forens Med, Chongqing 400016, Peoples R China; [Wu, Qi-Long; Wang, Qi; Guo, Gao-Xian; Li, Yong-Guo; Xing, Yu; Zhao, Min-Zhu; Li, Jian-Bo] Chongqing Engn Res Ctr Criminal Invest Technol, Chongqing 400016, Peoples R China; [Wu, Qi-Long; Wang, Qi; Guo, Gao-Xian; Li, Yong-Guo; Xing, Yu; Zhao, Min-Zhu; Li, Jian-Bo] Chongqing Key Lab Forens Med, Chongqing 400016, Peoples R China; [Li, Hongwei] Chongqing Publ Bur, Tech Dept Interpol Corps, Chongqing, Peoples R China"

通信作者："Zhao, MZ; Li, JB (通讯作者)，Chongqing Med Univ, Fac Basic Med Sci, Dept Forens Med, Chongqing 400016, Peoples R China."

来源：JOURNAL OF FORENSIC AND LEGAL MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000836542400002

JCR分区：Q2

影响因子：1.5

年份：2022

卷号：90

期号：　

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结束页：　

文献类型：Article

关键词：Atrial-oesophageal-thoracic fistula; Radiofrequency ablation; SEM-EDS

摘要："The report is about a 49-year-old man with rheumatic heart disease and atrial fibrillation. He underwent mitral valve replacement, tricuspid valvuloplasty, and atrial fibrillation radiofrequency ablation in the hospital. He vomited blood on the 2nd postoperative day, and the bleeding gradually worsened thereafter. He had to have repeated drainage of large amounts of blood from his right thoracic cavity and digestive tract. He died suddenly after undergoing an oesophageal endoscopy on the 24th postoperative day. The autopsy revealed an atrialoesophageal-thoracic fistula. By excluding the possibility of the fistula being caused by complications from nasoenteric feeding, tracheal intubation, and a foreign body ingestion, we determined that the atrialoesophageal-thoracic fistula was a complication after radiofrequency ablation according to the finding of coagulation necrosis of the myocardial cells at the left atrium fistula. In addition, we also performed an elemental analysis on the radiofrequency ablation area and other cardiac tissues by scanning electron microscopy-energy dispersive spectroscopy (SEM-EDS) and found five metal elements, Cr, Cu, Zn, Mn, and Ti, which specifically existed in the radiofrequency ablation area. This finding has the potential to serve as new evidence for radiofrequency ablation and is a worthy direction of research."

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