# A Case Report of a Strangulated Diaphragmatic Laceration: An Uncommon Late Complication of Cardiac Ablation

## TL;DR

A rare case of diaphragmatic laceration after cardiac ablation led to gastric fundus strangulation and required surgical intervention.

## Contribution

First reported case of diaphragmatic laceration as a late complication of ventricular ablation.

## Key findings

- Diaphragmatic laceration occurred two years after transcutaneous ventricular ablation.
- Surgical repair resolved the gastric fundus incarceration and diaphragmatic defect.
- No postoperative complications were observed following the intervention.

## Abstract

Background and Clinical Significance: In recent years, the catheter ablation of cardiac arrhythmias has significantly reduced the incidence of sudden cardiac deaths and the need for chronic antiarrhythmic therapy. Endocardial ablation of ventricular arrhythmias is less common than atrial ablation and is technically more challenging. There are few documented extracardiac complications for ventricular ablation, and there is no report of diaphragmatic laceration. Case Presentation: We report a case of acute diaphragmatic laceration following endovascular ventricular ablation resulting in the strangulation of the gastric fundus in a patient who experienced previous transcutaneous ventricular ablation two years before. The patient underwent exploratory laparoscopy, revealing a diaphragmatic laceration with incarceration of the gastric fundus. Resection of the gastric fundus, showing acute ischemic damage, and closure of the diaphragmatic defect near the right ventricle with sutures were required. No complications were observed in the postoperative course. Conclusions: Although diaphragmatic injury is extremely rare, it should be considered among the complications associated with ventricular ablation.