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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
