Imaging approaches for pulmonary vein isolation in patients after lobectomy or pneumonectomy: a case series

Abstract

Background In patients who underwent pneumonectomy, pulmonary vein isolation (PVI) for atrial fibrillation by catheter ablation may be complicated by the anatomical alterations caused by the surgical intervention. Pre- and peri-procedural imaging can visualize and guide the procedure to assure safety and procedural success. Case Summary This case series describe different imaging and ablation strategies in 3 cases from 3 different ablation centres with the unusually challenging and complex anatomical conditions in patients following lobectomy or pneumonectomy. Discussion PVI in patients with previous pulmonary resection was feasible by both radiofrequency and cryocatheter ablation despite the anatomical alterations caused by the surgery. Pre- and periprocedural imaging by cardiac computed tomography and transesophageal echocardiography contributed to an increased understanding of the complex anatomical substrate.