Moving Air in the Esophagus During Cryoballoon Ablation.

A 56-year-old male patient underwent cryoballoon ablation for symptomatic paroxysmal atrial fibrillation. Massive air movement reminiscent of an air esophagram was detected during cryoballoon application in the right superior pulmonary vein. In this case report, we sought to consider all possible explanations of this finding.

Gastroparesis as a Complication of Atrial Fibrillation Ablation.

Percutaneous catheter ablation is a safe and effective treatment for symptomatic drug-resistant atrial fibrillation (AF). Gastroparesis is a little known complication of AF ablation. We aimed to evaluate the frequency of gastroparesis in the patients who underwent catheter ablation for AF by cryoballoon (CB) or radiofrequency (RF) and to define risk factors for gastroparesis. In all, 104 patients were treated with pulmonary vein (PV) isolation with 2 different technologies: CB in 58 patients (group 1) and open-irrigated tip RF catheter in 46 patients (group 2). Gastroparesis was seen in 7 cases (6 cases in group 1 and 1 case in group 2, respectively). The complaints related with gastroparesis began during the procedure in 4 of 6 patients of group 1. The other 3 patients admitted to our outpatient clinic with similar complaints within 72 to 96 hours after the procedure. For gastroparesis cases of group 1, mean minimal CB temperature on inferior PVs was lower and left atrium diameter was smaller. Management was conservative, and the patients have no residual symptoms at 6-month follow-up. The only patient still demonstrating residual symptoms during follow-up was in group 2. Although, clinically manifest gastroparesis is quite common with CB ablation, the process is generally reversible. However, damage may not be as reversible with RF ablation. In conclusion, during cryoablation, lower temperatures on inferior PVs and small left atrium size may be associated with increased risk of gastroparesis, and fluoroscopic guidance may be useful to avoid this complication.

Primary abdominal wall actinomycosis.

PURPOSE: Actinomycosis is a progressive, chronic, granulomatous and suppurative disease caused by different types of actinomyces. Instead of chronic suppurative disease, sinus formation can also be seen. Cervicofascial, abdominal and thoracal involvement can occur. Abdominal wall actinomycosis is an infrequent clinical form. Isolated anterior wall actinomycosis is a very rare form of the disease. METHODS: This is an interventional case report. RESULTS: A 62-year-old female patient with abdominal mass was referred to hospital. She had diabetes mellitus. On the examination she had abdominal tenderness. The computerized tomography revealed an irregular density sized 6.5 × 5 × 3.5 cm in the umbilical area. Surgical debridement and incisional biopsy performed. The diagnosis is confirmed by histopathological examination. The patient received parenteral crystalline penicillin treatment and recovered. CONCLUSION: Physicians should consider abdominal wall actinomycosis in the cases of abdominal masses especially in immunosuppressive patients.