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Pulmonary Vein Stenosis Can Follow Arrhythmia Treatment

Last Updated: April 21, 2009.

Pulmonary vein stenosis can be a serious complication following ablation procedures for atrial fibrillation, which are becoming a more commonly used treatment, according to a review published in the April issue of the Journal of the American College of Cardiology: Cardiovascular Interventions.

TUESDAY, April 21 (HealthDay News) -- Pulmonary vein stenosis can be a serious complication following ablation procedures for atrial fibrillation, which are becoming a more commonly used treatment, according to a review published in the April issue of the Journal of the American College of Cardiology: Cardiovascular Interventions.

David R. Holmes, Jr., M.D., of the Mayo Clinic in Rochester, Minn., and colleagues provide an overview of the diagnosis and treatment of pulmonary vein stenosis following ablation for atrial fibrillation, a procedure that's attempted roughly 40,000 times or more each year in the United States.

Some patients with mild pulmonary vein stenosis are asymptomatic, but those with greater involvement may develop cough, dyspnea and hemoptysis that could be attributed to bronchopneumonia or other lung conditions, the researchers note. Early detection is important, and computed tomography is the best method of evaluation. The authors discuss treatment approaches, including dilation and stenting. Follow-up includes close monitoring for recurrent symptoms and possibly additional computed tomography.

"Pulmonary vein stenosis as a result of catheter ablation occurs in 1 to 3 percent of patients even in experienced centers. The presentation and clinical course of these patients is very variable. Treatment of pulmonary vein stenosis involves both anatomic and physiologic considerations. Recurrent stenosis is relatively frequent. Controversy exists about the role of initial stent placement versus provisional stenting. For recurrent stenoses, stenting is required," the authors conclude.

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