Insights into guidewire related complication during HotBalloon ablation in patients with atrial fibrillation: What should we know?

A 78-year-old woman with drug-resistant persistent atrial fibrillation was referred for catheter ablation by HotBalloon. All pulmonary veins were successfully ablated by the HotBalloon. During the additional roof ablation by the HotBalloon, sudden hemoptysis developed. It was observed that a guidewire advanced far distal to the left superior pulmonary vein (LSPV) branch. The pulmonary vein angiography demonstrated LSPV branch injury. After activated clotting time control, the hemoptysis disappeared spontaneously. The patient was discharged 6 days after the procedure without any sequela.