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3 . 2024

Gastroparesis after cryoablation of pulmonary veins

Abstract

We present a clinical case and a literature review describing the development of gastroparesis after cryoablation of the pulmonary vein ostia.

We used the PubMed database, the Google Scholar search engine, and reference lists to search for the scientific articles on the subject. Publications relevant to the purpose of the review were selected for the period from 2005 to 2023 using the terms: “gastroparesis”, “pathogenesis”, “diagnosis”, “treatment”. Inclusion criteria were limited mainly to the development of gastroparesis after ablation of the pulmonary vein ostia for the treatment of atrial fibrillation.

Literature analysis demonstrated that gastroparesis after ablation of the pulmonary veins was  common, but often undiagnosed, complication in the treatment of atrial fibrillation. Timely diagnosis and conservative therapy in most cases relieved developed symptoms.

Keywords: gastroparesis; atrial fibrillation; ablation of the pulmonary veins; complications

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

For citation: Belov D.V., Abramovskikh O.S., Sprikut A.A., Bryukhov V.A., Belova E.A. Gastroparesis after cryoablation of pulmonary veins. Clinical and Experimental Surgery. Petrovsky Journal. 2024; 12 (3): 110–4. DOI: https://doi.org/10.33029/2308-1198-2024-12-3-110-114 (in Russian)

References

1.     Sunata Y., Mori H., Hirai Y., Kubosawa Y., Banno S., et al. A case of gastroparesis after cryoballoon ablation followed by medication-induced recovery within 6 months. Case Rep Gastroenterol. 2018; 12 (2): 473–8. DOI: https://doi.org/10.1159/000492213   

2.     Garg L., Garg J., Gupta N., Shah N., Krishnamoorthy P., et  al. Gastrointestinal complications associated with catheter ablation for atrial fibrillation. Int J Cardiol. 2016; 224: 424–30. DOI:  https://doi.org/10.1016/j.ijcard.2016.09.069

3.     Shah D., Dumonceau J.M., Burri H., Sunthorn H., Schroft  A., et al. Acute pyloric spasm and gastric hypomotility: an extracardiac adverse effect of percutaneous radiofrequency ablation for atrial fibrillation. J Am Coll Cardiol. 2005; 46: 327–30. DOI: https://doi.org/10.1016/j.jacc.2005.04.030

4.     Park S.Y., Camilleri M., Packer D., Monahan K. Upper gastrointestinal complications following ablation therapy for atrial fibrillation. Neurogastroenterol Motil. 2017; 29 (11): 1–19 DOI: https://doi.org/10.1111/nmo.13109

5.     Knopp H., Halm U., Lamberts R., Knigge I., Zachäus M., et  al. Incidental and ablation-induced findings during upper gastrointestinal endoscopy in patients after ablation of atrial fibrillation: a retrospective study of 425 patients. Heart Rhythm. 2014; 11: 574–8. DOI: https://doi.org/10.1016/j.hrthm.2014.01.010

6.     Lakkireddy D., Reddy Y.M., Atkins D., Rajasingh J., Kanmanthareddy A., et al. Effect of atrial fibrillation ablation on gastric motility: the atrial fibrillation gut study. Circ Arrhythm Electrophysiol. 2015; 8 (3): 531–6. DOI: https://doi.org/10.1161/CIRCEP.114.002508

7.     Akhtar T., Calkins H., Bulat R., Pollack M.M., Spragg D.D. Atrial fibrillation ablation-induced gastroparesis: a case report and literature review. Heart Rhythm Case Rep. 2020; 6 (5): 249–52. DOI: https://doi.org/10.1016/j.hrcr.20 20.01.004

8.     Kannan L., Fahim A. Atrial fibrillation gut syndrome: severe gastroparesis with pyloric spasm following radiofrequency catheter ablation of drug resistant symptomatic atrial fibrillation: a case report. J Med Case Rep. 2023; 17 (1): 172. DOI: https://doi.org/10.1186/s13256-023-03829-w

9.     Miyazaki S., Kobori A., Jo H., Keida T., Yoshitani K., et al. Symptomatic gastroparesis after cryoballoon-based atrial fibrillation ablation: results from a large multicenter registry. Circ Arrhythm Electrophysiol. 2023; 16 (3): e011605. DOI: https://doi.org/10.1161/CIRCEP.122.011605

10. Nullens S., Naegels S., Ruytjens I. Gastric distension and gastroparesis following pulmonary vein isolation for atrial fibrillation: a case report and review of the literature. Acta Gastroenterol Belg. 2022; 85 (3): 531–4. DOI: https://doi.org/10.51821/85.3.9112

11. 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 (5): 1330–6. DOI: https://doi.org/10.1002/joa3.12625

12. Tanabe J., Shimizu A., Watanabe N., Endo A., Tanabe  K. Severe Gastroparesis After Ablation for Atrial Fibrillation. Cureus. 2020; 12 (6): 8610. DOI: https://doi.org/10.7759/cureus.8610

13. Miyazaki S., Nakamura H., Taniguchi H., Hachiya H., Takagi T., et al. Gastric hypomotility after second-generation cryoballoon ablation – unrecognized silent nerve injury after cryoballoon ablation. Heart Rhythm. 2017; 14 (5): 670–7. DOI: https://doi.org/10.1016/j.hrthm.2017.01.028  

14. Alsamman M., Ashraf B., Dankyi B., Aggarwal N. Fix the heart, damage the gut: a case report and literature review of ablation-induced gastroparesis. Cureus. 2022; 14 (4): 23946. DOI:  https://doi.org/10.7759/cureus.23946

15. Zipursky J.S., Shadowitz S. Severe gastroparesis after catheter ablation for atrial fibrillation. CMAJ. 2017; 189 (9): 368. DOI: https://doi.org/10.1503/cmaj.160335

16. Choi S.W., Kang S.H., Kwon O.S., Park H.W., Lee S., et al. A case of severe gastroparesis: indigestion and weight loss after catheter ablation of atrial fibrillation. Pacing Clin Electrophysiol. 2012; 35 (3): 59–61. DOI: https://doi.org/10.1111/j.1540-8159.2010.02912.x

17. Wattchow D., Heitmann P., Smolilo D., Spencer N.J., Parker D., et al. Postoperative ileus – in ongoing conundrum. Neurogastroenterol Motil. 2021; 33 (5): 14046. DOI: https://doi.org/10.1111/nmo.14046

18. Gundling F., Fuchs M., Schepp W., Fox M. G-POEM in patients with gastroparesis - gambling for healing or bigger armamentarium? A case series and review of the literature. Acta Gastroenterol Belg. 2020; 83 (3): 475–8.

19. Grover M., Farrugia G., Stanghellini V. Gastroparesis: a turning point in understanding and treatment. Gut. 2019; 68 (12): 2238–50. DOI: https://doi.org/10.1136/gutjnl-2019-318712

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CHIEF EDITOR
CHIEF EDITOR
Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)
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