Transcatheter angioplasty for acquired pulmonary vein stenosis after radiofrequency ablation

• Published in: Circulation (New York, N.Y.) N.Y.), 2003-09, Vol.108 (11), p.1336-1342
• Main Authors: QURESHI, Athar M, PRIETO, Lourdes R, NATALE, Andrea, RHODES, John F, LATSON, Larry A, LANE, Geoffrey K, MESIA, C. Igor, RADVANSKY, Penelope, WHITE, Richard D, MARROUCHE, Nassir F, SAAD, Eduardo B, BASH, Dianna L
• Format: Article
• Language: English
• Subjects: Angioplasty, Balloon - adverse effects; Atrial Fibrillation - surgery; Biological and medical sciences; Cardiac dysrhythmias; Cardiology. Vascular system; Catheter Ablation - adverse effects; Female; Heart; Humans; Male; Medical sciences; Middle Aged; Pulmonary Veins - diagnostic imaging; Pulmonary Veno-Occlusive Disease - diagnosis; Pulmonary Veno-Occlusive Disease - etiology; Pulmonary Veno-Occlusive Disease - therapy; Retrospective Studies; Tomography, Spiral Computed
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/01.cir.0000086322.21781.6a

Pulmonary vein stenosis has recently been recognized as a complication of radiofrequency ablation for atrial fibrillation. This study evaluates the presentation of affected patients and the role of transcatheter therapy for this patient population. This study used a retrospective review of data from 19 patients (age, 51+/-13 years) with pulmonary vein stenosis who underwent catheterization and angiography between December 2000 and December 2002. Quantitative perfusion and spiral CT scans were performed for initial diagnosis and follow-up. The median duration between radiofrequency ablation and the reported onset of respiratory symptoms for 18 of 19 patients was 7.5 weeks (0.1 to 48). After the onset of symptoms, all but two patients were initially misdiagnosed with a symptoms-to-diagnosis duration of 16 weeks (2-59). At initial catheterization, 17 of 19 patients had angioplasty in 30 veins with stent placement in 5 vessels when a flap occurred. Overall vessel diameter increased from 2.6+/-1.6 to 6.6+/-2.4 mm (P