Key result
Preexisting pulmonary vein stenosis (≥50%) was detected by pre-ablation MRA or MDCT in 2.8% (5 of 178) of patients with drug-refractory atrial fibrillation.
Why the study?
What is the prevalence and morphology of preexisting pulmonary vein stenosis in patients undergoing atrial fibrillation ablation?
Case Report (n=178)
What is the prevalence and morphology of preexisting pulmonary vein stenosis in patients undergoing atrial fibrillation ablation?
Pre-ablation 3D CT or MRA can detect preexisting pulmonary vein stenosis in about 2.8% of AF patients, preventing misdiagnosis of ablation-related stenosis.
May warrant pre-ablation MRA/MDCT to detect preexisting PV stenosis; leaves open true prevalence and ablation planning impact.
INTRODUCTION: Acquired pulmonary vein (PV) stenosis is a well-known complication following catheter ablation of atrial fibrillation (AF). However, the details of congenital PV stenosis have not been reported in patients who underwent catheter ablation of AF. METHODS AND RESULTS: A total of 178 patients (110 men, age: 54 +/- 11 years) with drug-refractory AF received MRA or multidetector CT (MDCT) before ablation for delineation of PV morphologies. Five PVs in 5 patients (2.8%) showed at least 50% stenosis before ablation. We demonstrated two types of preexisting PV stenosis. Type I is the external compression of PV by the descending aorta, observed in LIPV of the three patients. Type II is the focal narrowing of PV, observed in RSPV of the two patients. CONCLUSION: Preexisting stenosis of PV may be a consequence of congenital focal narrowing or external compression by the adjacent structures. Detection of this condition by 3D CT or MRA before catheter ablation can provide information for planning of ablation strategy and prevent misdiagnosis of ablation-related PV stenosis.
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Wongcharoen et al. (2005) conducted a case report in Drug-refractory atrial fibrillation (n=178). MRA or multidetector CT (MDCT) before ablation was evaluated on Preexisting pulmonary vein stenosis of at least 50%. Preexisting pulmonary vein stenosis (≥50%) was detected by pre-ablation MRA or MDCT in 2.8% (5 of 178) of patients with drug-refractory atrial fibrillation.
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