Esophago-pericardial fistula after catheter ablation of atrial fibrillation: A review.

INTRODUCTION: Much have been reported about esophago-left atrium fistula. However, esophago-mediastinal fistula, not reaching the left atrium, has not been studied as a different clinical entity, with different management. METHODS AND RESULTS: We review and discuss the literature of esophago-mediastinum fistula after catheter ablation for atrial fibrillation with emphasis on the following points: the timing of its occurrence after ablation; the mechanisms and localization of the fistula; and its natural history. CONCLUSION: We showed that esophageal stenting was associated with a better outcome in patients with esophagus-mediastinal fistula, introduced the concept of left atrial wall weakening during ablation, and suggest a possible role of contact force use in fistula formation.

Cardiac metastasizing leiomyoma: A case report.

INTRODUCTION: Cardiac intracavitary growth of metastasizing tumour is unusual. Benign Metastasizing Leiomyoma (BML) from the uterus to the heart is extremely rare. It affects premenopausal women with a history of uterine leiomyoma. PRESENTATION OF CASE: We report a case of a 42-year-old woman who presented three tumours in the right side of the heart, two years after a hysterectomy due to leiomyomatosis. The cardiac tumours were resected and the diagnosis was uterine leiomyoma. DISCUSSION: The patient developed cardiac failure due to three masses at the right side of the heart. Cardiac involvement in BML is usually asymptomatic and rare. The heart masses were surgically removed and a peri ovarian mass was detected and also removed. Although histologically benign, BML exhibits metastatic qualities. CONCLUSION: It suggests that BML should be included as a differential diagnosis when a female patient presents an intra cardiac mass and a history of hysterectomy.