Xu Lingping, Cui Lei, Hou Junlong, Wang Jing, Chen Bin, Xue Xianjun, Yang Ye, Wu Jine, Chen Jianhui
Department of Cardiovascular Medicine, Xianyang Central Hospital, Xianyang, Shaanxi, China.
Department of Ultrasound, Xianyang Central Hospital, Xianyang, Shaanxi, China.
J Int Med Res. 2020 Mar;48(3):300060519881555. doi: 10.1177/0300060519881555. Epub 2019 Nov 10.
Pulmonary vein stenosis (PVS) is a serious complication in patients with atrial fibrillation (AF) receiving radiofrequency catheter ablation (RFCA). We therefore examined these patients' clinical characteristics in relation to PVS occurrence.
We retrospectively analyzed the clinical symptoms, diagnostic procedures, and treatment strategies in patients with AF who developed PVS after RFCA.
Among 205 patients with AF who underwent RFCA, five (2.44%) developed PVS (all men; age 44-64 years; AF history 12-60 months; 2 paroxysmal AF, 3 persistent AF). One patient underwent two RFCA sessions and the others received one. The time to PVS diagnosed by pulmonary vein computed tomography angiography (CTA) was 3 to 21 months. PVS symptoms included dyspnea and hemoptysis. Nine pulmonary veins developed PVS. Single mild PVS occurred in two asymptomatic patients and multiple PVS or single severe PVS in three symptomatic patients who underwent pulmonary vein angiography and stent placement. Symptoms in the three patients significantly improved after stent implantation; however, stent restenosis occurred 1 year later in one case.
PVS is a rare complication of RFCA for AF that can be diagnosed by CTA. Pulmonary vein stent implantation can remarkably improve the symptoms, but stent restenosis may occur.
肺静脉狭窄（PVS）是接受射频导管消融术（RFCA）的心房颤动（AF）患者的一种严重并发症。因此，我们研究了这些患者与PVS发生相关的临床特征。
我们回顾性分析了RFCA术后发生PVS的AF患者的临床症状、诊断程序和治疗策略。
在205例行RFCA的AF患者中，5例（2.44%）发生PVS（均为男性；年龄44 - 64岁；AF病史12 - 60个月；2例阵发性AF，3例持续性AF）。1例患者接受了两次RFCA治疗，其余患者接受了一次。通过肺静脉计算机断层血管造影（CTA）诊断出PVS的时间为3至21个月。PVS症状包括呼吸困难和咯血。9条肺静脉发生PVS。2例无症状患者出现单一轻度PVS，3例有症状患者接受肺静脉血管造影和支架置入术，出现多条肺静脉狭窄或单一重度PVS。3例患者在支架植入后症状明显改善；然而，1例患者在1年后出现支架再狭窄。
PVS是AF患者RFCA术后罕见的并发症，可通过CTA诊断。肺静脉支架置入术可显著改善症状，但可能发生支架再狭窄。
