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.