Abstract
A 70-year-old man was treated with catheter ablation for symptomatic paroxysmal atrial fibrillation (AF). The treatment consisted of pulmonary vein isolation and radiofrequency ablation of the cavo-tricuspid isthmus line. However, the patient started vomiting two days after ablation. Abdominal radiography and plain abdominal computed tomography revealed gastric distension and massive accumulation of food residues. Esophagogastroduodenoscopy after fasting for two days revealed no organic stricture; food residues were retained in the stomach but not in the duodenum, suggesting gastroparesis. The most likely mechanism underlying gastroparesis associated with AF ablation is collateral periesophageal vagal nerve injury. Mosapride citrate is considered effective for symptoms.
Highlights
Catheter ablation (CA) is a widely accepted therapy for patients with symptomatic paroxysmal or persistent atrial fibrillation (AF)
The major gastrointestinal complications associated with CA include atrioesophageal fistula, gastroparesis, esophageal thermal lesions and esophageal ulcers [1,2]
We report a rare case of severe gastroparesis after CA for paroxysmal AF
Summary
Catheter ablation (CA) is a widely accepted therapy for patients with symptomatic paroxysmal or persistent atrial fibrillation (AF). He had a history of small bowel resection due to intestinal obstruction at the age of 19 years. Abdominal radiography and plain abdominal computed tomography (Figure 3) revealed gastric distension and massive accumulation of food residues. The patient was discharged five days after ablation therapy. His symptoms improved one week after administration of mosapride citrate. The patient continued receiving mosapride citrate, and abdominal symptoms did not recur three months after discharge
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