Pulmonary Vein Occlusion and Lung Infarction after Radiofrequency Ablation of Atrial Fibrillation. 2020

Julyan Al Fori, and Maryam Al Belushi, and Mohammed Al Shuraiqi, and Ghalia Al Mohanny, and Rashid Al Umairi, and Nasser Al Busaidi
Department of Chest Medicine, The Royal Hospital, Muscat, Oman.

BACKGROUND Pulmonary vein (PV) radiofrequency ablation (RFA) is an effective technique for a selected group of patients with atrial fibrillation (AF) refractory to antiarrhythmic drugs (Alfudhili et al., 2017). However, pulmonary vein occlusion is a potentially rare, sometimes severe, complication which may present clinically as nonspecific respiratory symptoms, signifying pulmonary vein stenosis, that are often underrecognized or misdiagnosed, leading to progression of the low-grade stenosis to complete occlusion if not treated with timely intervention (Alfudhili et al., 2017). Case Presentation. We report the first case of haemoptysis, three months postradiofrequency ablation (i.e., late complication) secondary to pulmonary vein occlusion that was diagnosed by computed tomography angiogram (CTA), which showed occlusion of 2 out of 4 native pulmonary veins. CONCLUSIONS The cause of haemoptysis in this patient was pulmonary vein occlusion, secondary to radiofrequency ablation, as demonstrated in the CTA.

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