Intrduction
Atrial Fibrillation is supraventricular tachyarrhythmia with uncoordinated atrial electrical activation and consequently ineffective atrial contraction. Pulmonary vein (PV) has been identified as a trigger for atrial fibrillation (AF), and electric pulmonary vein isolation (PVI) has become the cornerstone of ablation therapy in patients with paroxysmal atrial fibrillation [1]. Radiofrequency (RF) catheter ablation and cryoballoon ablation are the two main methods to achieve PVI isolation[2][3]. Clinical studies have shown esophageal injury in up to 20% of post-ablation AF patients, with AEF occurring in<1:1000 after RF ablation and <1:10,000 after cryoballoon ablation.[4][5] AEF is a catastrophic iatrogenic complication with the mortality rate of 80%[1] . Though esophageal thermal injury from cryoenergy ablation is rare, delayed observation and treatment could progress the relatively superficial thermal injury into the AEF causing a devastating outcome. A high level of suspicion in recognizing the post cryo-ablation thermal injury is paramount.