Pulmonary haemodynamics at rest and during exercise in patients with significant pulmonary vein stenosis after radiofrequency catheter ablation for drug resistant atrial fibrillation

Arentz, Thomas; Weber, Reinhold; Jander, Nikolaus; Bürkle, Gerd; Rosenthal, Jörg von; Blum, Thomas; Stockinger, Jochem; Haegeli, Laurent; Neumann, Franz Josef; Kalusche, D.

doi:10.1093/eurheartj/ehi279

Cited by 41 publications

(19 citation statements)

References 21 publications

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“…This was only seen in the worst cases having 3 or more stenosed veins and was relieved after dilation. It was shown in a recent study that despite the absence of pulmonary hypertension at rest, there is lack of decline or even increase in pulmonary artery pressure with exercise (21). Although exercise testing was not routinely evaluated, after a relatively long follow-up period, none of our The importance of timely intervention.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Vein Total Occlusion Following Catheter Ablation for Atrial Fibrillation

Biase

Fahmy

Wazni

et al. 2006

Journal of the American College of Cardiology

128

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Section: Discussionmentioning

confidence: 99%

Pulmonary Vein Total Occlusion Following Catheter Ablation for Atrial Fibrillation

Biase

Fahmy

Wazni

et al. 2006

Journal of the American College of Cardiology

128

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show abstract

“…In addition, central venous lines serve as a conduit for Swan-Ganz catheters, which are used to monitor CVP and measure the heart's effectiveness as a pump (Arentz et al, 2005). Central venous lines also provide a pathway for insertion of temporary cardiac pacemakers, and are useful in other situations where there is poor peripheral access (Rosen et al, 2001).…”

Section: Clinical Significance Of Ijv and Ejv Abnormalitiesmentioning

confidence: 99%

Bilateral duplicated internal jugular veins: Case study and literature review

et al. 2006

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A rare bilateral duplication of the internal jugular vein (IJV) was discovered during cadaveric dissection. From each jugular foramen, a single IJV descended to the level of the hyoid bone then divided into medial and lateral veins. The medial IJVs traveled in the carotid sheath; the lateral IJVs coursed posterolateral to the sheath across the lateral cervical region (posterior triangle) of the neck. On the right side, medial and lateral IJVs entered the subclavian vein separately. C2-C3 anterior rami and the suprascapular artery passed between the medial and lateral IJVs. The right external jugular vein passed aberrantly between the heads of the sternocleidomastoid muscle (SCM) into the subclavian vein anterior to the lateral IJV. On the left side, the medial IJV drained into a large bulbous jugulovertebrosubclavian (JVS) sinus that received six main vessels. The lateral IJV diverged posterolaterally toward the border of the trapezius muscle, received the transverse cervical vein, and then turned sharply anteromedially to drain into the JVS sinus. The lateral IJV also gave an aberrant additional large vein that passed laterally around the omohyoid muscle before entering the JVS sinus. The left external jugular vein paralleled the anterior border of SCM before passing posterolaterally to terminate in the JVS sinus. Jugular vein anomalies of this magnitude are very rare. Determining the frequency of multiple IJVs is hampered by inconsistent terminology. We suggest that IJV duplication differs from fenestration anatomically and, potentially, developmentally. Criteria for characterizing IJV duplication and fenestration are proposed. The mechanism of development and the clinical significance of multiple IJVs are discussed.

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“…3,[15][16][17] More recently, a circumferential RF ablation approach has been recommended and results in fewer complications when compared to a distal pulmonary vein or osteal approach. 3, 18 Rostamian recently reviewed 41 publications to determine the incidence of PVS and changes in incidence over time. 19 Since 2004 the mean incidence of PVS has been 2% and the median incidence has been 3.1% in published studies.…”

Section: Pulmonary Vein Isolation: Techniques Strategies and Advancmentioning

confidence: 99%

“…49 Another important contributing conditions are the number of stenosed PVs (more than one), and the number of previous ablation procedures (Table 1 with of PVS due to congestion upstream from the obstruction, and that sometimes requires intervention such as bronchosocpy. 14,18,51 Pulmonary vein stenosis treatment…”

Section: A N U S C R I P Tmentioning

confidence: 99%

Pulmonary vein stenosis complicating radiofrequency catheter ablation for atrial fibrillation: A literature review

Edriss

Denega

Test

et al. 2016

Respiratory Medicine

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Radiofrequency catheter ablation has become a widely used intervention in the treatment of atrial fibrillation. Pulmonary vein stenosis (PVS) is one of the most serious complications associated with this procedure; the degree of stenosis ranges from mild (<50%) to complete venous occlusion. The natural history of PVS and the risk of progression of existing PVS are uncertain. Symptomatic and/or severe PVS is a serious medical problem and can be easily misdiagnosed since it is an uncommon and relatively new medical problem, often has low clinical suspicion among clinicians, and has a non-specific presentation that mimics other more common respiratory or cardiac diseases. The estimated incidence varies in literature reports from 0% to 42% of ablation procedures, depending on technical aspects of the procedure and operator skill. Most patients with significant PVS remain asymptomatic or have few symptoms. Symptomatic patients usually present with dyspnea, chest pain, or hemoptysis and are usually treated with balloon angioplasty and/or stent placement. Little is known about the long term effect of PV stenosis/occlusion on the pulmonary circulation and the development of pulmonary hypertension. Evolving technology may reduce the frequency of this complication, but long term studies are needed to understand the effect of therapeutic atrial injury and adverse outcomes. This review summarizes the current literature and outlines an approach to the evaluation and management of these patients.

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Pulmonary haemodynamics at rest and during exercise in patients with significant pulmonary vein stenosis after radiofrequency catheter ablation for drug resistant atrial fibrillation

Abstract: Significant stenosis/occlusions of one or two PV do not create pulmonary hypertension at rest during long-term follow-up. However, seven of the 11 patients develop pulmonary hypertension during exercise. All three patients with stenosis/occlusions of two PV were affected.

Cited by 41 publications

References 21 publications

Pulmonary Vein Total Occlusion Following Catheter Ablation for Atrial Fibrillation

Pulmonary Vein Total Occlusion Following Catheter Ablation for Atrial Fibrillation

Bilateral duplicated internal jugular veins: Case study and literature review

Pulmonary vein stenosis complicating radiofrequency catheter ablation for atrial fibrillation: A literature review

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