A pulmonary vein remnant after lobectomy can serve as an arrhythmogenic source for atrial fibrillation, highlighting the importance of antrum isolation.
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PV remnants may trigger AF post-lobectomy; case report leaves open whether antral isolation prevents recurrence.
Atrial tachyarrhythmias are frequently observed after lung surgery. A 78-year-old woman underwent left inferior lobectomy for lung cancer. Paroxysmal atrial fibrillation was frequently observed after the surgery not only at acute phase but also at chronic phase. Six months after the surgery, she underwent pulmonary vein (PV) antrum isolation. Two circular mapping catheters placed in left ipsilateral PVs ostium revealed that frequent premature atrial contractions (PACs) and PAC salvos originated from the left inferior PV remnant (Figure). Whether or not surgical truncation impacted on the arrhythmogenicity of PV remnant, this case highlights the importance of antrum isolation of PV. Conflict of interest: none declared.
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Miyazaki et al. (2013) studied this question.
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