Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Lobectomy due to Pulmonary Vein Occlusion after Radiofrequency Ablation for Atrial Fibrillation

  • Papakonstantinou, Nikolaos A. (Department of Cardiothoracic Surgery, Evangelismos General Hospital of Athens) ;
  • Zisis, Charalambos (Department of Cardiothoracic Surgery, Evangelismos General Hospital of Athens) ;
  • Kouvidou, Charikleia (Department of Anatomic Pathology, Evangelismos General Hospital of Athens) ;
  • Stratakos, Grigoris (Department of 1st Pulmonary Medicine, Thoracic Diseases General Hospital Sotiria, National and Kapodistrian University of Athens)
  • Received : 2018.03.19
  • Accepted : 2018.04.17
  • Published : 2018.08.05
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Abstract

Radiofrequency ablation is an effective treatment for atrial fibrillation. Pulmonary vein stenosis/occlusion is one of its rare complications. Herein, the case of a 50-year-old man with hemoptysis and migratory pulmonary infiltrations after transcatheter radiofrequency ablation for atrial fibrillation is presented. Initially, pneumonia, interstitial pulmonary disease, or lung cancer was suspected, but wedge resection revealed hemorrhagic infiltrations. Chest computed tomography pulmonary angiography detected no left superior pulmonary vein due to its total occlusion, and left upper lobectomy was performed. Post-ablation pulmonary vein occlusion must be strongly suspected in cases of migratory pulmonary infiltrations and/or hemoptysis.

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References

  1. Packer DL, Keelan P, Munger TM, et al. Clinical presentation, investigation, and management of pulmonary vein stenosis complicating ablation for atrial fibrillation. Circulation 2005;111:546-54. https://doi.org/10.1161/01.CIR.0000154541.58478.36
  2. Di Biase L, Fahmy TS, Wazni OM, et al. Pulmonary vein total occlusion following catheter ablation for atrial fibrillation: clinical implications after long-term follow-up. J Am Coll Cardiol 2006;48:2493-9. https://doi.org/10.1016/j.jacc.2006.08.038
  3. Libretti L, Ciriaco P, Zannini P. Pulmonary vein stenosis requiring lobectomy after radiofrequency catheter ablation for atrial fibrillation. J Cardiovasc Surg (Torino) 2012;53:821-3.
  4. Baman TS, Jongnarangsin K, Chugh A, et al. Prevalence and predictors of complications of radiofrequency catheter ablation for atrial fibrillation. J Cardiovasc Electrophysiol 2011;22:626-31. https://doi.org/10.1111/j.1540-8167.2010.01995.x
  5. Piccini JP, Lopes RD, Kong MH, Hasselblad V, Jackson K, Al-Khatib SM. Pulmonary vein isolation for the maintenance of sinus rhythm in patients with atrial fibrillation: a meta-analysis of randomized, controlled trials. Circ Arrhythm Electrophysiol 2009;2:626-33. https://doi.org/10.1161/CIRCEP.109.856633
  6. Bertaglia E, Zoppo F, Tondo C, et al. Early complications of pulmonary vein catheter ablation for atrial fibrillation: a multicenter prospective registry on procedural safety. Heart Rhythm 2007;4:1265-71. https://doi.org/10.1016/j.hrthm.2007.06.016
  7. Cappato R, Calkins H, Chen SA, et al. Updated worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation. Circ Arrhythm Electrophysiol 2010;3:32-8. https://doi.org/10.1161/CIRCEP.109.859116
  8. Nehra D, Liberman M, Vagefi PA, et al. Complete pulmonary venous occlusion after radiofrequency ablation for atrial fibrillation. Ann Thorac Surg 2009;87:292-5. https://doi.org/10.1016/j.athoracsur.2008.06.060