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BackgroundAir embolus penetrating into heart chamber as a complication during percutaneous radiofrequency catheter ablation has been infrequently reported.Case presentationA 55-year-old man with dextrocardia who suffered from abdominal pain was suspected to have multiple arterial thromboembolisms, which might have originated from left atrium thrombosis since he had atrial fibrillation. He received oral anticoagulant therapy and catheter ablation of the arrhythmia. During the ablation procedure, an iatrogenic aeroembolism penetrated into the left atrium due to improper operation. Ultimately, the entire air embolus was extracted from the patient, who was free of any aeroembolism events thereafter.ConclusionsIt is essential for an operator to pay full attention to all details of the procedure to avoid an aeroembolism during catheter ablation. In case of aeroembolism, removal by aspiration is an optimal and effective treatment.Electronic supplementary materialThe online version of this article (doi:10.1186/s12872-017-0581-7) contains supplementary material, which is available to authorized users.

Introduction:Atrial-esophageal fistula (AEF) is a rare severe disease, which may be associated with radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) or intraoperative radiofrequency ablation of atrial fibrillation (IRAAF).Clinical Findings:We reported a case of a 67-year-old man with AEF following RFCA of AF, who treated with esophageal stenting and surgical repair.Outcomes:He was attacked by out-of-control sepsis and infectious shock after surgery and died.Literature review:We analyzed 57 relevant articles about AEF from 2003 to 2015 by searching PubMed database. According literatures, the most common symptoms were fever, rigor, sepsis, and neurologic symptoms. Chest computer tomography (CT) and contrast enhanced CT may be the reliable noninvasive diagnosis methods because of high sensitive for AEF.Conclusion:Make a definition diagnosis in time with early primary surgical repair may save their lives. Conservative treatment or esophageal stenting alone may not be a better choice for AEF patients.