Case Report
A 71-year-old female with symptomatic paroxysmal atrial fibrillation
underwent cryoballoon PV isolation. BMI 28kg/m2 She
presented medical history of hypertension. The transthoracic
echocardiography detected moderately enlarged left atrium and
transesophageal excluded a left atrial thrombus.
An 8-polar electrode catheter was inserted via right femoral access at
starter followed by successful single transseptal puncture.The operator
initiated the ablation respectively at all 4 PVs maneuvering the 28 mm
balloon-catheter. 9 ablation applications were performed (Table 1) — 2
times on left superior pulmonary vein(LSPV),2 on left inferior pulmonary
vein(LIPV), 2 on right superior pulmonary vein(RSPV), 3 on right
inferior pulmonary vein(RIPV), lowest temperature of LIPV is -51℃. No
additional RF ablations were supplemented. To maintain stable sinus
rhythm,an external electrical cardioversion was performed at the
endpoint of the ablation process, .
The following day the patients complained about dysphagia, and chest
pain exacerbated by swallowing. Arrange the patient with post-procedural
endoscopy which detected the esophageal thermal lesions(esophageal
erosion accompanied by hematoma in the anterior wall of esophagus) . The
patient predominantly underwent strict
fasting and water deprivation,supported by intravenous nutritional
liquids.The dose of
proton-pump-inhibitor was increased
to 40mg twice daily. The patients symptoms relieved progressively and
7th day after, we contact the same gastrointestinal
physician to repeat the endoscopy, it showed the absolute recovery of
esophageal mucosa(Figure 1). The patient was discharged the day after.
Table 1. Ablation duration time and balloon temperature