Hemoptysis after pulmonary vein isolation with a cryoballoon: an analysis of the potential etiology.

In a series of 359 cryoballoon ablations with a complete registry of complications, clinically important hemoptysis requiring readmission was observed in 2 patients. One patient had preexisting bronchiectasis; the other had no previous history of pulmonary disease. In the first patient the guiding wire was very distal in one of the veins and exceptional low freezing temperatures were recorded in the left inferior pulmonary vein. Similarly, in the second patient exceptional low freezing temperatures were recorded in all 4 veins. Four additional patients mentioned hemoptysis at the 3-month follow-up visit, which resolved after temporary cessation of anticoagulation. Hemoptysis can occur after cryoballoon ablation for several reasons, especially when a stringent anticoagulation regimen is adhered to, and when occlusion is associated with very low freezing temperatures.