Ishii Satoshi, Hosoda Junya, Iguchi Kohei, Fukui Kazuki, Hibi Kiyoshi
Department of Cardiology, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomioka-higashi, Kanazawa-ku, Yokohama 236-0051, Japan.
Eur Heart J Case Rep. 2025 Apr 29;9(5):ytaf204. doi: 10.1093/ehjcr/ytaf204. eCollection 2025 May.
Perioesophageal vagal nerve injury related to pulmonary vein isolation using radiofrequency catheter ablation sometimes causes somatic symptoms including gastric dilation and motility disorder. However, reports of acute acalculous cholecystitis after pulmonary vein isolation are rare.
We report a case of a 64-year-old man diagnosed with paroxysmal atrial fibrillation. No acute complications occurred on the day of the procedure, but he complained of epigastric pain 27 h after the ablation procedure. He was diagnosed with mild acute acalculous cholecystitis and underwent laparoscopic cholecystectomy.
Vagal nerve injury appears to be related to the development of acute acalculous cholecystitis because many patients with acute cholecystitis after abdominal surgery along with resection of vagal nerve have acute acalculous cholecystitis. We speculate that acute acalculous cholecystitis after pulmonary vein isolation is one phenotype of perioesophageal vagal nerve injury.
与使用射频导管消融术进行肺静脉隔离相关的食管周围迷走神经损伤有时会导致包括胃扩张和运动障碍在内的躯体症状。然而，肺静脉隔离术后急性非结石性胆囊炎的报道很少。
我们报告一例64岁男性，被诊断为阵发性心房颤动。手术当天未发生急性并发症，但他在消融术后27小时出现上腹部疼痛。他被诊断为轻度急性非结石性胆囊炎，并接受了腹腔镜胆囊切除术。
迷走神经损伤似乎与急性非结石性胆囊炎的发生有关，因为许多腹部手术后伴有迷走神经切除的急性胆囊炎患者患有急性非结石性胆囊炎。我们推测肺静脉隔离术后急性非结石性胆囊炎是食管周围迷走神经损伤的一种表现形式。
