The right and left vagus nerves form an anterior and posterior plexus called the periesophageal plexi that supply the stomach and the pyloric sphincter. Gastroparesis presenting as retention of food residue in the stomach is caused by damage to the vagal nerve fibers surrounding the distal esophagus, and because of its close proximity to the posterior wall of the left atrium and left pulmonic veins. involving 5380 patients undergoing AF ablation reported a 0.2% incidence of gastroparesis. in 2014 recruited 425 patients with symptomatic AF who underwent left atrial RFCA and subsequent EGD 1–3 days after the procedure, and who showed pathological gastrointestinal findings that included gastric erosion (22%), esophageal erythema (21%), gastroparesis (17%), thermal esophageal lesions, and reflux esophagitis. A retrospective study conducted by Knopp et al. Vagus nerve injury is one of the least known complications of radiofrequency catheter ablation for atrial fibrillation. The patient was afebrile with a blood pressure of 112/81 mm Hg, pulse of 74 beats per minute (regular), and respiratory rate of 20 breaths per minute. On the day of admission, physical examination revealed soft, distended, and nontender abdomen.
Notably, the patient had undergone direct current cardioversion (DCCV) of atrial fibrillation 8 months previously and cardiac ablation 5 months previously due to persistent symptoms. His only medications at the time of admission were omeprazole, amiodarone, ramipril, and Eliquis.
The patient denied any fever, cough, shortness of breath, abdominal pain, or recent use of antibiotics or nonsteroidal anti-inflammatory drugs (NSAIDs). Since discharge after undergoing radiofrequency catheter ablation for atrial fibrillation 2 weeks ago, he has been having nausea, multiple episodes of vomiting, bloating, and constipation. A 44-year-old Caucasian male with history of idiopathic cardiomyopathy, hypertension, atrial fibrillation, and depression presented to the hospital with nausea, vomiting, and decreased appetite for 2 weeks.
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