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Pulmonary Hemorrhage After Cryoballoon Ablation for Pulmonary Vein Isolation in the Treatment of Atrial FibrillationPulmonary Hemorrhage After Cryoballoon Ablation

Julio Martí-Almor, MD, PhD; Miguel E. Jauregui-Abularach, MD; Begoña Benito, MD; Ermengol Vallès, MD, PhD; Victor Bazan, MD, PhD; Albert Sánchez-Font, MD, PhD; Ivan Vollmer, MD; Carmen Altaba, RN; Miguel A. Guijo, RN; Manel Hervas, RN; Jordi Bruguera-Cortada, MD
Author and Funding Information

From the Electrophysiology Unit, Cardiovascular Department (Drs Martí-Almor, Jauregui-Abularach, Benito, Vallès, Bazan, and Bruguera-Cortada; Ms Altaba; and Messrs Guijo and Hervas), the Respiratory Medicine Department (Dr Sánchez-Font), and the Radiology-Imaging Department (Dr Vollmer), Hospital del Mar, Barcelona, Spain.

Correspondence to: Miguel E. Jauregui-Abularach, MD, Hospital del Mar, Cardiology, Passeig Marítim 25-29, Barcelona, Barcelona, Spain 08003; e-mail: mjauregui@parcdesalutmar.cat


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;145(1):156-157. doi:10.1378/chest.13-0761
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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.

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