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Catheter and Surgical Ablation of Atrial Fibrillation

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13 Table 5. Signs and Symptoms Following AF Ablation Differential Suggested evaluation Signs and symptoms of complications within a month postablation Back pain Musculoskeletal, retroperitoneal hematoma Physical exam, CT imaging Chest pain Pericarditis, pericardial effusion, coronary stenosis (ablation related), pulmonary vein stenosis, musculoskeletal (aer cardioversion), worsening reflux Physical exam, chest X-ray, ECG, echocardiogram, stress test, cardiac catheterization, chest CT Cough Infectious process, bronchial irritation (mechanical, cryoballoon), pulmonary vein stenosis Physical exam, chest X-ray, chest CT Dysphagia Esophageal irritation (related to transesophageal echocardiography), atrioesophageal fistula Physical exam, chest CT or MRI Early satiety, nausea Gastric denervation Physical exam, gastric emptying study Fever Infectious process, pericarditis, atrio-esophageal fistula Physical exam, chest X-ray, urinalysis, laboratory blood work Fever, dysphagia, neurologic symptoms Atrial esophageal fistula Physical exam, laboratory blood work, chest CT or MRI; avoid endoscopy with air insufflation Groin pain at site of access Pseudoaneurysm, AV fistula, hematoma Ultrasound of the groin, laboratory blood work; consider CT scan if ultrasound negative Headache Migraine (related to anesthesia or transseptal access, hemorrhagic stroke), effect of general anaesthetic Physical exam, brain imaging (MRI) Hypotension Pericardial effusion/tamponade, bleeding, sepsis, persistent vagal reaction Echocardiography, laboratory blood count Hemoptysis PV stenosis or occlusion, pneumonia CXR, chest CT or MR scan, VQ scan

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