title: Pulmonary vein isolation for atrial fibrillation in the postpneumonectomy population: a feasibility, safety, and outcomes study.
abstract: BACKGROUND
  Pulmonary vein isolation (PVI) of the remnant pulmonary vein (PV) stumps in pneumonectomy patients has not been well characterized.
  
  
  METHODS
  This is a multicenter observational study of patients with a remnant PV stump after pneumonectomy. Consecutive patients with a history of pneumonectomy and who had undergone RF ablation for drug refractory AF were identified from the AF database at the participating institutions.
  
  
  RESULTS
  There were 15 patients in whom pneumonectomy was performed, for resection of tumors in 10, infection in 4, and bullae in 1 patient and who underwent RF ablation for AF. The mean age was 63 ± 7 years. The stumps were from the right lower PV in 5, left upper PV in 5, left lower PV in 3, and right upper PV in 2 patients. All the PV stumps were electrically active with PV potentials and 9 (60%) of them had triggered activity. PVI was performed in 14 and focal isolation in 1 patient. At 1-year follow-up, 80% were free of AF, off of antiarrhythmic medications.
  
  
  CONCLUSIONS
  PV stumps in AF patients with previous pneumonectomy are electrically active and are frequently the sites of active firing. Isolation of these PV stumps can be accomplished safely and effectively using catheter ablation with no practical concern for PV stenosis or compromising PV stump integrity.
authors.affiliation: Division of Cardiology, Creighton University, Omaha, Nebraska, USA.
authors.forename: Arun
authors.initials: A
authors.lastname: Kanmanthareddy
authors.affiliation: Division of Cardiology, Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio, USA.
authors.forename: Ajay
authors.initials: A
authors.lastname: Vallakati
authors.affiliation: KU Cardiovascular Research Institute, The University of Kansas Hospital and Medical Center, Kansas City, Kansas, USA.
authors.forename: Madhu
authors.initials: M
authors.lastname: Reddy Yeruva
authors.affiliation: Division of Cardiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Dixit
authors.affiliation: Division of Cardiology, Albert Einstein Montefiore Medical Center, Bronx, New York, USA.
authors.forename: Luigi
authors.initials: L
authors.lastname: DI Biase
authors.affiliation: Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Moussa
authors.initials: M
authors.lastname: Mansour
authors.affiliation: Division of Cardiology, Howard University Hospital, Washington, District of Columbia, USA.
authors.forename: Hemant
authors.initials: H
authors.lastname: Boolani
authors.affiliation: KU Cardiovascular Research Institute, The University of Kansas Hospital and Medical Center, Kansas City, Kansas, USA.
authors.forename: Sampath
authors.initials: S
authors.lastname: Gunda
authors.affiliation: KU Cardiovascular Research Institute, The University of Kansas Hospital and Medical Center, Kansas City, Kansas, USA.
authors.forename: T Jared
authors.initials: TJ
authors.lastname: Bunch
authors.affiliation: Division of Cardiology, Intermountain Heart Institute, Salt Lake City, Utah, USA.
authors.forename: John D
authors.initials: JD
authors.lastname: Day
authors.affiliation: Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Jeremy N
authors.initials: JN
authors.lastname: Ruskin
authors.affiliation: KU Cardiovascular Research Institute, The University of Kansas Hospital and Medical Center, Kansas City, Kansas, USA.
authors.forename: Avanija
authors.initials: A
authors.lastname: Buddam
authors.affiliation: KU Cardiovascular Research Institute, The University of Kansas Hospital and Medical Center, Kansas City, Kansas, USA.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Koripalli
authors.affiliation: KU Cardiovascular Research Institute, The University of Kansas Hospital and Medical Center, Kansas City, Kansas, USA.
authors.forename: Sudharani
authors.initials: S
authors.lastname: Bommana
authors.affiliation: Division of Electrophysiology, Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Natale
authors.affiliation: KU Cardiovascular Research Institute, The University of Kansas Hospital and Medical Center, Kansas City, Kansas, USA.
authors.forename: Dhanunjaya
authors.initials: D
authors.lastname: Lakkireddy
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D022062:Electrophysiologic Techniques, Cardiac; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D011013:Pneumonectomy / Q000009:adverse effects*; D011667:Pulmonary Veins / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D015641:Radiography, Interventional; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014481:United States
keywords: atrial fibrillation ablation; atrial fibrillation after pneumonectomy; catheter ablation of pulmonary vein stump; efficacy of isolation of pulmonary vein stump; pulmonary vein stump