A Novel Case of Acute Respiratory Distress Syndrome Following Radiofrequency Ablation for Atrial Fibrillation.
| Autor: | Minviel GD; Internal Medicine, USF Health, Tampa, USA., Gosnell H; Internal Medicine, USF Health, Tampa, USA., Karivelil M; Internal Medicine, USF Health, Tampa, USA., Ugalde IC; Pulmonary and Critical Care Medicine, USF Health, Tampa, USA., Huang S; Internal Medicine-Pediatrics, USF Health, Tampa, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2023 May 15; Vol. 15 (5), pp. e39052. Date of Electronic Publication: 2023 May 15 (Print Publication: 2023). |
| DOI: | 10.7759/cureus.39052 |
| Abstrakt: | Radiofrequency ablation (RFA) is a minimally invasive cardiac catheterization procedure employed in patients whose atrial fibrillation (AF) is not well-controlled on medical therapy. While serious complications after the RFA are uncommon, we present the unique case of a 71-year-old male who suffered from acute respiratory distress syndrome (ARDS) and pneumomediastinum post-procedure. He presented to the ED with dyspnea, non-massive hemoptysis, and fever three days following RFA. Admission CT thorax demonstrated patchy ground glass opacities (GGOs) and stable fibrotic changes. He was admitted for suspected pneumonia, however, he failed to significantly improve on broad-spectrum antibiotics. Bronchoscopy found blood in proximal airways, however, lavage with serial aliquots were without worsening hemorrhage, ruling out suspected diffuse alveolar hemorrhage. Cytology resulted in rare iron polymorphonuclear neutrophils and no malignant cells. With worsening clinical status, the patient was eventually intubated. Repeat CT thorax showed new moderate pneumopericardium, small pneumomediastinum, and progressed GGOs. The respiratory course continued to worsen, and the patient passed away approximately one month after admission. We also present a brief literature review with the aim of identifying prognostic risk factors regarding post-RFA ARDS development. Additionally, this case identifies a novel complication of RFA, as post-procedural pneumomediastinum has not been previously described. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, Minviel et al.) |
| Databáze: | MEDLINE |
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