Late onset cardiac cirrhosis and portal hypertensive ascites after atrial fibrillation ablation

Abstract

Pulmonary vein stenosis is a potential complication following catheter ablation of atrial fibrillation (AF). We report the case of a patient with refractory ascites late after multiple catheter ablation procedures for AF. This is the first case report of portal hypertensive ascites due to acquired multiple pulmonary vein stenoses resulting in pulmonary hypertension (PH) and cardiac cirrhosis late after AF ablation. Despite extensive surgical reconstruction of the affected pulmonary veins, the patient has PH and right heart failure with persistent ascites and lower extremity edema.

Dual‐energy computed tomography‐angiography in the evaluation and management of significant multiple pulmonary vein stenoses following atrial fibrillation ablation

“… 2 , 3 The most common symptom is shortness of breath, and its severity depends on the number of affected veins. 4 , 5 PV stenosis is an example of postcapillary PH, which requires differentiation with PE and other PH causes. Perfusion scintigraphy, the most common screening tool for PE, has a low specificity for differential diagnosis.…”

“…We report on the use of dual‐energy CT iodine maps in the diagnosis of the functional severity of acquired multi‐vessel PV stenosis, which is a rare complication of atrial fibrillation ablation occurring in less than 1% of cases 2,3. The most common symptom is shortness of breath, and its severity depends on the number of affected veins 4,5. PV stenosis is an example of postcapillary PH, which requires differentiation with PE and other PH causes.…”