title: Asymptomatic Pulmonary Vein Stenosis: Hemodynamic Adaptation and Successful Ablation.
abstract: Pulmonary vein stenosis is a well-established possible complication following an atrial fibrillation ablation of pulmonary veins. Symptoms of pulmonary vein stenosis range from asymptomatic to severe exertional dyspnea. The number of asymptomatic patients with pulmonary vein stenosis is greater than originally estimated; moreover, only about 22% of severe pulmonary vein stenosis requires intervention. We present a patient with severe postatrial fibrillation (AF) ablation pulmonary vein (PV) stenosis, which was seen on multiple imaging modalities including cardiac computed tomography (CT) angiogram, lung perfusion scan, and pulmonary angiogram. This patient did not have any pulmonary symptoms. Hemodynamic changes within a stenosed pulmonary vein might not reflect the clinical severity of the obstruction if redistribution of pulmonary artery flow occurs. Our patient had an abnormal lung perfusion and ventilation (V/Q) scan, suggesting pulmonary artery blood flow redistribution. The patient ultimately underwent safe repeat atrial fibrillation ablation with successful elimination of arrhythmia.
authors.affiliation: University of Miami at Holy Cross Hospital, Fort Lauderdale, FL, USA.
authors.forename: John J
authors.identifier: 0000-0002-8505-9233
authors.initials: JJ
authors.lastname: Lee
authors.affiliation: South Florida Multispecialty Associates, LLC, Miami Beach, FL, USA.
authors.forename: Denis
authors.initials: D
authors.lastname: Weinberg
authors.affiliation: Holy Cross Hospital, Fort Lauderdale, FL, USA.
authors.forename: Rishi
authors.identifier: 0000-0002-4650-3012
authors.initials: R
authors.lastname: Anand