How to prevent, detect and manage complications caused by cryoballoon ablation of atrial fibrillation

Nitin Kulkarni, Wilber Su, Richard Wu

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Atrial fibrillation is the most common cardiac arrhythmia and the prevalence is increasing every year. Patients who fail to maintain sinus rhythm with use of anti-arrhythmic drug therapy are referred for catheter ablation. Cryoballoon (CB) ablation has emerged as an effective and alternative treatment option to traditional point-by-point radiofrequency ablation, but there can be complications. This article reviews the incidence, presentation, risk factors, management and preventative strategies of three major complications associated with CB ablation: phrenic nerve injury, atrial oesophageal fistula and bronchial injury. Although these complications are rare, electrophysiologists should institute measures to identify high-risk patients, implement best-practice techniques to minimise risks and maintain a high index of suspicion to recognise the complications quickly and implement correct treatment strategies.

Original languageEnglish (US)
Pages (from-to)18-23
Number of pages6
JournalArrhythmia and Electrophysiology Review
Issue number1
StatePublished - Mar 1 2018


  • Atrial fibrillation
  • Atrio-oesophageal fistula
  • Bronchial injury
  • Catheter ablation
  • Cryoablation
  • Cryoballoon
  • Dosing
  • Phrenic nerve injury

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


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