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房颤射频消融术后导致的肺静脉狭窄或闭塞可能被误诊为肺炎:一例病例报告。

Pulmonary vein stenosis or occlusion resulting from radiofrequency ablation of atrial fibrillation can be mistakenly diagnosed as pneumonia: a case report.

作者信息

Gong Jun Xian, Zong Ai Fen, Gong Yue Zhen

机构信息

Department of Cardiology, Huantai County People's Hospital, Zibo City, Shandong Province, China.

出版信息

Front Cardiovasc Med. 2025 Jan 23;11:1509227. doi: 10.3389/fcvm.2024.1509227. eCollection 2024.

DOI:10.3389/fcvm.2024.1509227
PMID:39917606
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11800114/
Abstract

The increased use of radiofrequency ablation (RFA) for atrial fibrillation (AF) has led to a rise in cases of pulmonary vein stenosis or occlusion (PVS/O) as a complication. While this occurrence was once rare, the growing number of patients undergoing this procedure has made it more prevalent. The actual frequency of pulmonary vein (PV) occlusion remains a topic of debate. This complication can present with non-specific respiratory symptoms, potentially leading to misdiagnosis and delayed treatment, with serious consequences. Clinical signs of PVS/O post-ablation can vary from no symptoms to common respiratory issues like coughing, hemoptysis, shortness of breath, and chest pain. Failure to promptly diagnose and address this condition may result in the need for lung lobectomy and even pose life-threatening risks.

摘要

心房颤动(AF)射频消融(RFA)使用的增加导致作为并发症的肺静脉狭窄或闭塞(PVS/O)病例增多。虽然这种情况曾经很少见,但接受该手术的患者数量不断增加,使其更为普遍。肺静脉(PV)闭塞的实际发生率仍是一个有争议的话题。这种并发症可能表现为非特异性呼吸道症状,可能导致误诊和治疗延迟,后果严重。消融术后PVS/O的临床体征从无症状到咳嗽、咯血、呼吸急促和胸痛等常见呼吸道问题不等。未能及时诊断和处理这种情况可能导致需要进行肺叶切除术,甚至带来危及生命的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f956/11800114/23e449055d28/fcvm-11-1509227-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f956/11800114/23e449055d28/fcvm-11-1509227-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f956/11800114/23e449055d28/fcvm-11-1509227-g001.jpg

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本文引用的文献

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Posterior wall ablation for persistent atrial fibrillation: Very-high-power short-duration versus standard-power radiofrequency ablation.持续性心房颤动的后壁消融:超高功率短程与标准功率射频消融
Heart Rhythm O2. 2024 Apr 26;5(6):374-384. doi: 10.1016/j.hroo.2024.04.011. eCollection 2024 Jun.
2
Pulsed field vs very high-power short-duration radiofrequency ablation for atrial fibrillation: Results of a multicenter, real-world experience.脉冲场与超高功率短时间射频消融治疗心房颤动:一项多中心真实世界经验的结果。
Heart Rhythm. 2024 Sep;21(9):1526-1536. doi: 10.1016/j.hrthm.2024.05.042. Epub 2024 May 27.
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High-power short-duration catheter ablation of atrial fibrillation: is it really a new era? Comparison between new and old radiofrequency contact force-sensing catheters.
高能短时导管消融治疗心房颤动:是否真的进入了新纪元?新旧两代射频接触力感知导管的比较。
J Interv Card Electrophysiol. 2024 Apr;67(3):549-557. doi: 10.1007/s10840-023-01612-x. Epub 2023 Aug 16.
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Pathogenesis, Evaluation, and Management of Pulmonary Vein Stenosis: JACC Review Topic of the Week.肺静脉狭窄的发病机制、评估和管理:JACC 每周综述专题。
J Am Coll Cardiol. 2023 Jun 20;81(24):2361-2373. doi: 10.1016/j.jacc.2023.04.016.
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Partially reversible lung consolidation after revascularization of a total occlusion of both left pulmonary veins following ablation of atrial fibrillation: a case report.房颤消融术后左肺静脉完全闭塞再血管化后部分可逆性肺实变:一例报告
Eur Heart J Case Rep. 2023 Feb 2;7(2):ytad057. doi: 10.1093/ehjcr/ytad057. eCollection 2023 Feb.
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Stent implantation for severe pulmonary vein stenosis or occlusion secondary to atrial fibrillation ablation.用于治疗房颤消融术后严重肺静脉狭窄或闭塞的支架植入术。
Int J Cardiol. 2020 Feb 15;301:85-89. doi: 10.1016/j.ijcard.2019.11.147. Epub 2019 Nov 28.
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