Balloon dilation successfully improved dyspnea and pulmonary hypertension in 2 patients who developed severe pulmonary vein stenosis 3 months after catheter ablation of atrial fibrillation.
Case Report (n=2)
What are the severe complications associated with radiofrequency catheter ablation within the pulmonary veins for atrial fibrillation?
Application of radiofrequency current within the pulmonary veins can cause life-threatening pulmonary vein stenosis, which may be treated with balloon dilation.
BACKGROUND: This report describes the complication of pulmonary vein stenosis with resultant severe pulmonary hypertension that developed in 2 patients after successful catheter ablation of chronic atrial fibrillation. METHODS AND RESULTS: Three months after successful catheter ablation of atrial fibrillation, both patients developed progressive dyspnea and pulmonary hypertension. Both were found to have severe stenosis of all 4 pulmonary veins near the junction with the left atrium. Balloon dilation of the stenotic pulmonary veins was performed in these patients, with improvement in dyspnea and pulmonary hypertension. CONCLUSIONS: The complication of pulmonary vein stenosis is potentially life-threatening, and the application of radiofrequency current within the pulmonary veins with standard catheter technology should be avoided. This complication can be treated with balloon dilation, although the long-term course is unknown.
Robbins et al. (1998) conducted a case report in Pulmonary vein stenosis after catheter ablation of atrial fibrillation (n=2). Balloon dilation was evaluated on Improvement in dyspnea and pulmonary hypertension. Balloon dilation successfully improved dyspnea and pulmonary hypertension in 2 patients who developed severe pulmonary vein stenosis 3 months after catheter ablation of atrial fibrillation.
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