Korean Circ J.  2024 Jun;54(6):357-360. 10.4070/kcj.2024.0009.

Symptomatic Gastroparesis After Cryoballoon Ablation for Atrial Fibrillation

• Cho S
• Lee JH
• Hwang ES

• KMID: 2556535
• DOI: http://doi.org/10.4070/kcj.2024.0009

Figure

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  Figure 1 Pre-procedural CT images and cine images during cryoballoon ablation. (A) Three-dimensional reconstructed LA image showed common anatomy of 4 PVs and (B) esophagus (*) position at the level of the PVs was middle which was classified when the midline of the esophagus was centered on the vertebrae. Cryoballoon ablation was performed at each 4 PV (C-F).CT = computed tomography; LA = left atrium; LAO = left anterior oblique; LIPV = left inferior pulmonary vein; LSPV = left superior pulmonary vein; PV = pulmonary vein; RAO = right anterior oblique; RIPV = right inferior pulmonary vein; RSPV = right superior pulmonary vein.

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  Figure 2 Abdomen X-ray, CT, and esophagogastroduodenoscopy images. Abdominal (A) X-ray and (B) CT images revealed severe gastric distension and (C) esophagogastroduodenoscopy showed large amount of undigested food residues without obstructing lesion.CT = computed tomography.

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  Figure 3 Serial abdomen CT follow-up images at 3 and 6 months. (A) Three months follow-up CT showed still distended but slightly improved gastric distension compared to initial CT and (B) 6 months follow-up CT revealed almost complete recovery of gastroparesis.CT = computed tomography.

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  Figure 4 The relative position of the left atrium, esophagus, and periesophageal vagal nerve and mechanism of collateral cryothermal damage of periesophageal vagal nerve during cryoballoon ablation.

Reference

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2. Akhtar T, Calkins H, Bulat R, Pollack MM, Spragg DD. Atrial fibrillation ablation-induced gastroparesis: a case report and literature review. HeartRhythm Case Rep. 2020; 6:249–252. PMID: 32461887.

3. Yakabe D, Fukuyama Y, Araki M, Nakamura T. Anatomical evaluation of the esophagus using computed tomography to predict acute gastroparesis following atrial fibrillation ablation. J Arrhythm. 2021; 37:1330–1336. PMID: 34621432.