Preexisting pulmonary vein stenosis in patients undergoing atrial fibrillation ablation: a report of five cases.
BACKGROUND
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.


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.


CONCLUSIONS
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.
Wongcharoen
Wanwarang
W
Division of Cardiology and Cardiovascular Research Center, National Yang-Ming University School of Medicine, Taiwan, China.
Tsao
Hsuan-Ming
HM
Wu
Mei-Han
MH
Tai
Ching-Tai
CT
Chang
Shih-Lin
SL
Lin
Yenn-Jiang
YJ
Chang
Cheng-Yen
CY
Chen
Shih-Ann
SA
D000328:Adult; D001281:Atrial Fibrillation / Q000150:complications / Q000601:surgery*; D017115:Catheter Ablation; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011668:Pulmonary Veno-Occlusive Disease / Q000150:complications* / Q000175:diagnosis; D012307:Risk Factors; D014057:Tomography, X-Ray Computed