We read the article entitled “Gastroparesis as a complication of atrial fibrillation ablation” by Aksu et al. They presented their experiences in regard to cryoballoon ablation of atrial fibrillation (AF). In the study, a relatively high prevalence of symptomatic gastroparesis, 6 of 58 (10.3%) patients with cryoballoon application, was found, and more cooling of the inferior veins and smaller left atrial size were found to be associated with gastroparesis in contrary to previous reports. Some important issues related to the study should be mentioned. (1) What may be the mechanisms for gastroparesis in this study? Close anatomic relation between the periesophageal nerve plexus and more posteriorly located inferior pulmonary veins and posterior left atrium may result in collateral damage to the nerve fibers, especially in patients with inflated balloons in the veins instead of the antrum. In addition, relatively larger sized balloons compared to smaller atria may result in inappropriate cooling of the posterior wall, especially with the application of the external forces through the body of the catheter and the sheath to occlude the veins. (2) Although the investigators had some exclusion criteria, it has been known that diabetes is one of the major causes of gastroparesis, and no data were reported about the ratio of the diabetic patients with gastroparesis or blood glucose levels that hyperglycemia is associated with antral hypomotility. In addition, no data were presented related to other less-common causes such as eating disorders, thyroid functions (hypothyroidism) and used drugs (i.e. diabetic agents such as glucagon-like peptide-1 analogues) which have been demonstrated as gastroparesis risk factors. (3) There are some inconsistencies about the methods and results of the study. First, patients underwent one of the ablation methods randomly in the methods section. However, the investigators have stated that the study was not a randomized one at the end of the report. Second, statistically significant difference is seen in regard to left atrial diameter between the 2 groups although they mentioned comparable baseline characteristics. Radiofrequency ablation group had larger left atria. This may be due to patient selection for ablation method that point-by-point radiofrequency ablation may be the preferred method in patients with larger atrium and persistent AF. Third, all pulmonary veins in both groups were isolated in the study. In the cryo group (n = 58), all 232 veins were isolated although 3 patients had left-sided common ostium. Finally, no data were found regarding the mean left atrial diameter in patients with gastroparesis although the investigators have concluded that smaller left atrial diameter was associated with symptomatic gastroparesis.