title: Pulmonary hemorrhage after cryoballoon ablation for pulmonary vein isolation in the treatment of atrial fibrillation.
abstract: Pulmonary vein isolation has evolved over the past years as an alternative for the treatment of symptomatic recurrences of atrial fibrillation refractory to antiarrhythmic drug treatment. Both radiofrequency energy and cryoballoon ablation have proven useful in this setting. We present the case of a 55-year-old male patient undergoing cryoballoon ablation complicated with pulmonary hemorrhage. The cause of this rare complication may be found in the damage of vascular venous structures near the ablation zone or, alternatively, in hemorrhagic damage of the pulmonary vein surrounding tissue (or less probably to direct injury of the lingular bronchus). The extremely low temperatures achieved in this case (which are often associated with deep balloon position inside the veins) are alarming and should alert the physician about the possibility of an excessively intrapulmonary vein deployment of the cryoablation balloon.
authors.affiliation: Electrophysiology Unit, Cardiovascular Department, Hospital del Mar, Barcelona, Spain.
authors.forename: Julio
authors.initials: J
authors.lastname: Martí-Almor
authors.affiliation: Electrophysiology Unit, Cardiovascular Department, Hospital del Mar, Barcelona, Spain. Electronic address: mjauregui@parcdesalutmar.cat.
authors.forename: Miguel E
authors.initials: ME
authors.lastname: Jauregui-Abularach
authors.affiliation: Electrophysiology Unit, Cardiovascular Department, Hospital del Mar, Barcelona, Spain.
authors.forename: Begoña
authors.initials: B
authors.lastname: Benito
authors.affiliation: Electrophysiology Unit, Cardiovascular Department, Hospital del Mar, Barcelona, Spain.
authors.forename: Ermengol
authors.initials: E
authors.lastname: Vallès
authors.affiliation: Electrophysiology Unit, Cardiovascular Department, Hospital del Mar, Barcelona, Spain.
authors.forename: Victor
authors.initials: V
authors.lastname: Bazan
authors.affiliation: Respiratory Medicine Department, Hospital del Mar, Barcelona, Spain.
authors.forename: Albert
authors.initials: A
authors.lastname: Sánchez-Font
authors.affiliation: Radiology-Imaging Department, Hospital del Mar, Barcelona, Spain.
authors.forename: Ivan
authors.initials: I
authors.lastname: Vollmer
authors.affiliation: Electrophysiology Unit, Cardiovascular Department, Hospital del Mar, Barcelona, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Altaba
authors.affiliation: Electrophysiology Unit, Cardiovascular Department, Hospital del Mar, Barcelona, Spain.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Guijo
authors.affiliation: Electrophysiology Unit, Cardiovascular Department, Hospital del Mar, Barcelona, Spain.
authors.forename: Manel
authors.initials: M
authors.lastname: Hervas
authors.affiliation: Electrophysiology Unit, Cardiovascular Department, Hospital del Mar, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Bruguera-Cortada
mesh_terms: D001281:Atrial Fibrillation / Q000601:surgery*; D003452:Cryosurgery / Q000009:adverse effects*; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D008171:Lung Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery*