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Journal of Medical Case Reports

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Open Access 01-12-2023 | Nausea | Case report

Atrial fibrillation gut syndrome: severe gastroparesis with pyloric spasm following radiofrequency catheter ablation of drug resistant symptomatic atrial fibrillation: a case report

Authors: Lakshmi Kannan, Anfal Fahim

Published in: Journal of Medical Case Reports | Issue 1/2023

Abstract

Background

Atrial fibrillation is the most common cardiac arrhythmia, and cardiac ablation is one of the treatment modalities for persistent symptomatic atrial fibrillation. Gastroparesis is a rare complication of radiofrequency catheter ablation for atrial fibrillation, which may be associated with high morbidity.

Case presentation

We present a 44-year-old Caucasian male with persistent atrial fibrillation who presented with nausea, vomiting, bloating, and constipation after radiofrequency catheter ablation. He was found to have gastroparesis due to pyloric spasm that was treated with botulinum toxin injection.

Conclusion

This case signifies the importance of identifying gastric complications after radiofrequency catheter ablation atrial fibrillation, and the need for prompt diagnosis and treatment of gastroparesis with botulinum toxin injection.

Aksu T, Golcuk S, Guler TE, Yalin K, Erden I. Gastroparesis as a complication of atrial fibrillation ablation. Am J Cardiol. 2015;116:92–7. https://doi.org/10.1016/j.amjcard.2015.03.045.CrossRefPubMed

Lakkireddy D, Reddy YM, Atkins D, Rajasingh J, Kanmanthareddy A, Olyaee M, et al. Effect of atrial fibrillation ablation on gastric motility. Circ Arrhythm Electrophysiol. 2015;8:531–6. https://doi.org/10.1161/CIRCEP.114.002508.CrossRefPubMed

Knopp H, Halm U, Lamberts R, Knigge I, Zachäus M, Sommer P, 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. https://doi.org/10.1016/j.hrthm.2014.01.010.CrossRefPubMed

Park S-Y, Camilleri M, Packer D, Monahan K. Upper gastrointestinal complications following ablation therapy for atrial fibrillation. Neurogastroenterol Motil. 2017;29:e13109. https://doi.org/10.1111/nmo.13109.CrossRef

Kuwahara T, Takahashi A, Takahashi Y, Kobori A, Miyazaki S, Takei A, et al. Clinical characteristics and management of periesophageal vagal nerve injury complicating left atrial ablation of atrial fibrillation: lessons from eleven cases. J Cardiovasc Electrophysiol. 2013;24:847–51. https://doi.org/10.1111/jce.12130.CrossRefPubMed

Pisani CF, Hachul D, Sosa E, Scanavacca M. Gastric hypomotility following epicardial vagal denervation ablation to treat atrial fibrillation. J Cardiovasc Electrophysiol. 2008;19:211–3. https://doi.org/10.1111/j.1540-8167.2007.00937.x.CrossRefPubMed

Choi SW, Kang SH, Kwon OS, Park HW, Lee S, Koo BS, et al. A case of severe gastroparesis: indigestion and weight loss after catheter ablation of atrial fibrillation. Pacing Clin Electrophysiol. 2012;35:e59-61. https://doi.org/10.1111/j.1540-8159.2010.02912.x.CrossRefPubMed

Koruth JS, Reddy VY, Miller MA, Patel KK, Coffey JO, Fischer A, et al. Mechanical esophageal displacement during catheter ablation for atrial fibrillation. J Cardiovasc Electrophysiol. 2012;23:147–54. https://doi.org/10.1111/j.1540-8167.2011.02162.x.CrossRefPubMed

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

10.

Nakov R, Habermann E, Hertting G, Wurster S, Allgaier C. Effects of botulinum A toxin on presynaptic modulation of evoked transmitter release. Eur J Pharmacol. 1989;164:45–53. https://doi.org/10.1016/0014-2999(89)90229-X.CrossRefPubMed

Title: Atrial fibrillation gut syndrome: severe gastroparesis with pyloric spasm following radiofrequency catheter ablation of drug resistant symptomatic atrial fibrillation: a case report
Authors: Lakshmi Kannan
Anfal Fahim
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Nausea
Constipation
Atrial Fibrillation
Esophagogastroduodenoscopy
Botulinum Toxin
Constipation
Published in: Journal of Medical Case Reports / Issue 1/2023
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/s13256-023-03829-w

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Atrial fibrillation gut syndrome: severe gastroparesis with pyloric spasm following radiofrequency catheter ablation of drug resistant symptomatic atrial fibrillation: a case report

Abstract

Background

Case presentation

Conclusion

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