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Gastric distension and gastroparesis following pulmonary vein isolation for atrial fibrillation: a case report and review of the literature

Ahead of print available from 27/06/2022
These articles are scheduled for publication in Vol. 85 (3) 2022

Author(s) S. Nullens 1, S. Naegels 1, I. Ruytjens 1
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DOI10.51821/85.3.9112
Affiliations:
(1) Department of Gastroenterology and Hepatology, ZNA Middelheim Hospital, Antwerp, Belgium.

We present a case of marked gastric distension and gastroparesis in a patient with atrial fibrillation who underwent a pulmonary vein isolation, a procedure commonly performed in patients suffering from atrial fibrillation in order to regain sinus rhythm. Two days following the procedure, the patient presented with marked abdominal distension, and computed tomography imaging was consistent with gastroparesis and/or delayed gastric emptying. A tentative diagnosis of pylorospasm was made. After a first attempt with a conservative approach, gastroscopy with both pyloric dilatation and intra-pyloric botox injection was performed due to persisting discomfort. The symptoms gradually resolved following this intervention. Gastroparesis and gastrointestinal distension is a rare complication following pulmonary vein isolation, and is mainly thought to result from temporary damaging the vagal nerve. Since a rising number of patients undergo an ablation of the pulmonary veins as treatment for atrial fibrillation, gastroenterologists should become aware of this probably not so rare complication.

Keywords: pulmonary vein isolation, gastroparesis, vagal nerve, pylorospasm
The authors declare that they have no conflict of interest.
© Acta Gastro-Enterologica Belgica.