scholarly journals Clinical characteristics of patients with atrial fibrillation suffering from pulmonary vein stenosis after radiofrequency ablation

2019 ◽  
Vol 48 (3) ◽  
pp. 030006051988155
Author(s):  
Lingping Xu ◽  
Lei Cui ◽  
Junlong Hou ◽  
Jing Wang ◽  
Bin Chen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Stent Implantation ◽  
Clinical Characteristics ◽  
Rare Complication ◽  
Pulmonary Veins ◽  
Pulmonary Vein Stenosis ◽  
Stent Restenosis ◽  
Asymptomatic Patients ◽  
Vein Stenosis

Objective Pulmonary vein stenosis (PVS) is a serious complication in patients with atrial fibrillation (AF) receiving radiofrequency catheter ablation (RFCA). We therefore examined these patients’ clinical characteristics in relation to PVS occurrence. Method We retrospectively analyzed the clinical symptoms, diagnostic procedures, and treatment strategies in patients with AF who developed PVS after RFCA. Results Among 205 patients with AF who underwent RFCA, five (2.44%) developed PVS (all men; age 44–64 years; AF history 12–60 months; 2 paroxysmal AF, 3 persistent AF). One patient underwent two RFCA sessions and the others received one. The time to PVS diagnosed by pulmonary vein computed tomography angiography (CTA) was 3 to 21 months. PVS symptoms included dyspnea and hemoptysis. Nine pulmonary veins developed PVS. Single mild PVS occurred in two asymptomatic patients and multiple PVS or single severe PVS in three symptomatic patients who underwent pulmonary vein angiography and stent placement. Symptoms in the three patients significantly improved after stent implantation; however, stent restenosis occurred 1 year later in one case. Conclusion PVS is a rare complication of RFCA for AF that can be diagnosed by CTA. Pulmonary vein stent implantation can remarkably improve the symptoms, but stent restenosis may occur.

scholarly journals Asymptomatic Pulmonary Vein Stenosis: Hemodynamic Adaptation and Successful Ablation

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
John J. Lee ◽  
Denis Weinberg ◽  
Rishi Anand
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Artery ◽  
Pulmonary Vein ◽  
Pulmonary Veins ◽  
Lung Perfusion ◽  
Atrial Fibrillation Ablation ◽  
Clinical Severity ◽  
Pulmonary Vein Stenosis ◽  
Multiple Imaging ◽  
Vein Stenosis

Pulmonary vein stenosis is a well-established possible complication following an atrial fibrillation ablation of pulmonary veins. Symptoms of pulmonary vein stenosis range from asymptomatic to severe exertional dyspnea. The number of asymptomatic patients with pulmonary vein stenosis is greater than originally estimated; moreover, only about 22% of severe pulmonary vein stenosis requires intervention. We present a patient with severe postatrial fibrillation (AF) ablation pulmonary vein (PV) stenosis, which was seen on multiple imaging modalities including cardiac computed tomography (CT) angiogram, lung perfusion scan, and pulmonary angiogram. This patient did not have any pulmonary symptoms. Hemodynamic changes within a stenosed pulmonary vein might not reflect the clinical severity of the obstruction if redistribution of pulmonary artery flow occurs. Our patient had an abnormal lung perfusion and ventilation (V/Q) scan, suggesting pulmonary artery blood flow redistribution. The patient ultimately underwent safe repeat atrial fibrillation ablation with successful elimination of arrhythmia.

CT Visualization and Histopathological Assessment of Cryoablation in Pulmonary Veins

2009 ◽  
Author(s):  
Mithun M. Shenoi ◽  
Xiaoqing Zhang ◽  
Ramji T. Venkatasubramanian ◽  
Erin D. Grassl ◽  
Lenny George ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Veins ◽  
The United States ◽  
The Body ◽  
Pulmonary Vein Stenosis ◽  
Invasive Technique ◽  
Freezing Process ◽  
Ectopic Beats ◽  
Vein Stenosis

Over 2 million adults in the United States are affected by atrial fibrillation (AF), a common cardiac arrhythmia that is associated with decreased survival, increased cardiovascular morbidities, and a decrease in quality of life. Atrial fibrillation can be initiated by ectopic beats originating in the myocardial sleeves surrounding the pulmonary veins [1]. Pulmonary vein (PV) isolation via radiofrequency ablation is the current gold standard for treating patients with drug-refractory AF [2]. However, cryoablation is emerging as a new minimally-invasive technique to achieve PV isolation. Cryoablation is fast gaining acceptance due to its minimal tissue disruption, decreased thrombogenicity, and reduced complications (RF can lead to low rate of pulmonary vein stenosis) [2]. One important question in regard to this technology is whether the PV lesion is transmural and circumferential and to what extent adjacent tissues are involved in the freezing process. As ice formation lends itself to image contrast in the body, we hypothesized that intraprocedural CT visualization of the iceball formation would allow us to predict the extent of the cryolesion and/or provide us with a measure of the adjacent tissue damage.

scholarly journals Pulmonary Vein Occlusion and Lung Infarction after Radiofrequency Ablation of Atrial Fibrillation

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Julyan Al Fori ◽  
Maryam Al Belushi ◽  
Mohammed Al Shuraiqi ◽  
Ghalia Al Mohanny ◽  
Rashid Al Umairi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Pulmonary Vein ◽  
Late Complication ◽  
Pulmonary Veins ◽  
Pulmonary Vein Stenosis ◽  
Low Grade ◽  
Vein Occlusion ◽  
First Case ◽  
Vein Stenosis

Background. Pulmonary vein (PV) radiofrequency ablation (RFA) is an effective technique for a selected group of patients with atrial fibrillation (AF) refractory to antiarrhythmic drugs (Alfudhili et al., 2017). However, pulmonary vein occlusion is a potentially rare, sometimes severe, complication which may present clinically as nonspecific respiratory symptoms, signifying pulmonary vein stenosis, that are often underrecognized or misdiagnosed, leading to progression of the low-grade stenosis to complete occlusion if not treated with timely intervention (Alfudhili et al., 2017). Case Presentation. We report the first case of haemoptysis, three months postradiofrequency ablation (i.e., late complication) secondary to pulmonary vein occlusion that was diagnosed by computed tomography angiogram (CTA), which showed occlusion of 2 out of 4 native pulmonary veins. Conclusion. The cause of haemoptysis in this patient was pulmonary vein occlusion, secondary to radiofrequency ablation, as demonstrated in the CTA.

scholarly journals Complications of the Catheter Treatment of Atrial Fibrillation: Stenosis of All Pulmonary Veins after Radiofrequency Ablation

Kardiologiia ◽  
2019 ◽  
Vol 59 (5) ◽  
pp. 92-96
Author(s):  
E. V. Merkulov ◽  
O. V. Sapelnikov ◽  
E. E. Vlasova ◽  
O. A. Nikolaeva ◽  
D. I. Cherkashin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Catheter Ablation ◽  
Pulmonary Vein ◽  
Gold Standard ◽  
Clinical Case ◽  
Pulmonary Veins ◽  
Pulmonary Vein Stenosis ◽  
Vein Stenosis

Radiofrequency ablation is the “gold standard” in atrial fibrillation treatment. The frequency of complications is about 3.5–3.9 %. The symptomatic pulmonary vein stenosis is one of the most severe complications. In this report we present a clinical case of stenosis of all four pulmonary veins after redo catheter ablation of atrial fibrillation in 61year-old patient, and discussion of possible causes, specific features of diagnosis, and possible approaches to treatment of this complication.

281 Incidence of asymptomatic pulmonary vein stenosis in atrial fibrillation ablation. Segmental ostial ablation versus pulmonary veins encircling

EP Europace ◽  
2005 ◽  
Vol 7 (Supplement_1) ◽  
pp. 62-63
Author(s):  
D. Tamborero ◽  
J.L. Mont Girbau ◽  
I. Molina ◽  
T.M. De Caralt ◽  
S. Nava ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Veins ◽  
Atrial Fibrillation Ablation ◽  
Pulmonary Vein Stenosis ◽  
Vein Stenosis
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