Silent takotsubo cardiomyopathy after cryoballoon ablation

An 86-year-old woman without structural heart disease underwent cryoballoon pulmonary vein isolation and cavotricuspid isthmus ablation of symptomatic short-lasting persistent atrial fibrillation. Coronary angiography revealed normal coronary arteries. The next day, she was asymptomatic, however, a routine 12-lead electrogram and echocardiography revealed new-onset T-wave inversion and newly developed left ventricular (LV) apical dyskinesis (Figure, arrows). The LV wall motion and electrogram entirely normalized 3 days and 3 months later, respectively, without any specific treatment. The case highlighted takotsubo cardiomyopathy after cryoballoon ablation and the importance of follow-up 12-lead electrograms to avoid missing this possibly silent complication, especially in aged populations.