Esophageal Hematoma
The esophagus can be injured directly as a result of trauma from a transesophageal probe. Esophageal hematoma is a recognized complication after a transesophageal echo study, which can be performed in association with the ablation procedure.1161 A recent study reported that 0.27% of the patients who underwent an AF ablation with a preprocedure TEE experienced this complication. The predominant symptoms were pain on swallowing, regurgitation, and hoarseness, with an onset within 12 hours of the procedure. Fever and neurological symptoms were not present. The diagnosis was established by a CT scan, which ruled out an AEF and revealed a hematoma localized to either the upper esophagus or extending the length of the esophagus. Endoscopy can further confirm the diagnosis. Conservative management is advised. Long-term consequences of this complication include an esophageal stricture, esophageal dysmotility, and vocal cord paralysis.1161