A rare case of right heart failure with the necessity for veno‐arterial extracorporeal membrane oxygenation following pulmonary vein stenosis after radiofrequency ablation for atrial fibrillation
Abstract Pulmonary vein stenosis (PVS) after radiofrequency energy‐mediated percutaneous pulmonary vein isolation as a treatment option for atrial fibrillation is a serious complication and the prevalence in historical reports varies between 0% and 42%. Symptoms of PVS are nonspecific and can includ...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-01-01
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| Series: | Pulmonary Circulation |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/pul2.12189 |
| _version_ | 1827944746096525312 |
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| author | Sabrina Kopp Marie‐Kristin Tilch Ingo Sagoschen Joachim Kaes Malte Kuniss Thomas Neumann Yang Yang Katharina Schnitzler Kai‐Helge Schmidt Thomas Rostock Thomas Münzel Stavros Konstantinides Johannes Wild Lukas Hobohm |
| author_facet | Sabrina Kopp Marie‐Kristin Tilch Ingo Sagoschen Joachim Kaes Malte Kuniss Thomas Neumann Yang Yang Katharina Schnitzler Kai‐Helge Schmidt Thomas Rostock Thomas Münzel Stavros Konstantinides Johannes Wild Lukas Hobohm |
| author_sort | Sabrina Kopp |
| collection | DOAJ |
| description | Abstract Pulmonary vein stenosis (PVS) after radiofrequency energy‐mediated percutaneous pulmonary vein isolation as a treatment option for atrial fibrillation is a serious complication and the prevalence in historical reports varies between 0% and 42%. Symptoms of PVS are nonspecific and can include general symptoms such as dyspnea, cough, recurrent pneumonia, and chest pain. Pathophysiologically it increases the postcapillary pressure in the pulmonary circuit and may result in pulmonary hypertension (PH). Misdiagnosis and delayed treatment are common. We here report a case of a 59‐year‐old female with a history of pulmonary vein ablation followed by progressive dyspnea (New York Heart Association IV), right heart failure, CPR, and the need for extracorporeal membrane oxygenation (ECMO). Further treatment strategy includes pulmonary vein dilatation and stenting of both the left superior pulmonary vein and left inferior pulmonary vein, as well as balloon dilatation of RIPV under temporary ECMO support. Symptomatic, severe PVS is a rare complication after catheter ablation of atrial fibrillation. PVS can result in life‐threatening complications such as PH with acute right heart failure. Early diagnosis is crucial but challenging. Mechanical cardiopulmonary support by veno‐arterial ECMO for bridging to angioplasty could be a lifesaving option. |
| first_indexed | 2024-03-13T10:34:51Z |
| format | Article |
| id | doaj.art-442199fea41145f89a6a6d2fc47a79cd |
| institution | Directory Open Access Journal |
| issn | 2045-8940 |
| language | English |
| last_indexed | 2024-03-13T10:34:51Z |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Pulmonary Circulation |
| spelling | doaj.art-442199fea41145f89a6a6d2fc47a79cd2023-05-18T06:26:29ZengWileyPulmonary Circulation2045-89402023-01-01131n/an/a10.1002/pul2.12189A rare case of right heart failure with the necessity for veno‐arterial extracorporeal membrane oxygenation following pulmonary vein stenosis after radiofrequency ablation for atrial fibrillationSabrina Kopp0Marie‐Kristin Tilch1Ingo Sagoschen2Joachim Kaes3Malte Kuniss4Thomas Neumann5Yang Yang6Katharina Schnitzler7Kai‐Helge Schmidt8Thomas RostockThomas Münzel9Stavros Konstantinides10Johannes Wild11Lukas Hobohm12Department of Cardiology, Cardiology I University Medical Center Mainz Mainz GermanyDepartment of Hematology, Oncology and Pneumology & University Cancer Center University Medical Center Mainz Mainz GermanyDepartment of Cardiology, Cardiology I University Medical Center Mainz Mainz GermanyDepartment of Cardiology, Cardiology I University Medical Center Mainz Mainz GermanyDepartment of Cardiology Kerckhoff Heart Center Bad Nauheim GermanyDepartment of Cardiology Kerckhoff Heart Center Bad Nauheim GermanyDepartment of Radiology University Medical Center Mainz Mainz GermanyDepartment of Cardiology, Cardiology I University Medical Center Mainz Mainz GermanyDepartment of Cardiology, Cardiology I University Medical Center Mainz Mainz GermanyDepartment of Cardiology, Cardiology I University Medical Center Mainz Mainz GermanyDepartment of Cardiology, Cardiology I University Medical Center Mainz Mainz GermanyDepartment of Cardiology, Cardiology I University Medical Center Mainz Mainz GermanyDepartment of Cardiology, Cardiology I University Medical Center Mainz Mainz GermanyAbstract Pulmonary vein stenosis (PVS) after radiofrequency energy‐mediated percutaneous pulmonary vein isolation as a treatment option for atrial fibrillation is a serious complication and the prevalence in historical reports varies between 0% and 42%. Symptoms of PVS are nonspecific and can include general symptoms such as dyspnea, cough, recurrent pneumonia, and chest pain. Pathophysiologically it increases the postcapillary pressure in the pulmonary circuit and may result in pulmonary hypertension (PH). Misdiagnosis and delayed treatment are common. We here report a case of a 59‐year‐old female with a history of pulmonary vein ablation followed by progressive dyspnea (New York Heart Association IV), right heart failure, CPR, and the need for extracorporeal membrane oxygenation (ECMO). Further treatment strategy includes pulmonary vein dilatation and stenting of both the left superior pulmonary vein and left inferior pulmonary vein, as well as balloon dilatation of RIPV under temporary ECMO support. Symptomatic, severe PVS is a rare complication after catheter ablation of atrial fibrillation. PVS can result in life‐threatening complications such as PH with acute right heart failure. Early diagnosis is crucial but challenging. Mechanical cardiopulmonary support by veno‐arterial ECMO for bridging to angioplasty could be a lifesaving option.https://doi.org/10.1002/pul2.12189catheter ablationextracorporeal membrane oxygenationpulmonary hypertensionpulmonary vein stenosisright heart failure |
| spellingShingle | Sabrina Kopp Marie‐Kristin Tilch Ingo Sagoschen Joachim Kaes Malte Kuniss Thomas Neumann Yang Yang Katharina Schnitzler Kai‐Helge Schmidt Thomas Rostock Thomas Münzel Stavros Konstantinides Johannes Wild Lukas Hobohm A rare case of right heart failure with the necessity for veno‐arterial extracorporeal membrane oxygenation following pulmonary vein stenosis after radiofrequency ablation for atrial fibrillation Pulmonary Circulation catheter ablation extracorporeal membrane oxygenation pulmonary hypertension pulmonary vein stenosis right heart failure |
| title | A rare case of right heart failure with the necessity for veno‐arterial extracorporeal membrane oxygenation following pulmonary vein stenosis after radiofrequency ablation for atrial fibrillation |
| title_full | A rare case of right heart failure with the necessity for veno‐arterial extracorporeal membrane oxygenation following pulmonary vein stenosis after radiofrequency ablation for atrial fibrillation |
| title_fullStr | A rare case of right heart failure with the necessity for veno‐arterial extracorporeal membrane oxygenation following pulmonary vein stenosis after radiofrequency ablation for atrial fibrillation |
| title_full_unstemmed | A rare case of right heart failure with the necessity for veno‐arterial extracorporeal membrane oxygenation following pulmonary vein stenosis after radiofrequency ablation for atrial fibrillation |
| title_short | A rare case of right heart failure with the necessity for veno‐arterial extracorporeal membrane oxygenation following pulmonary vein stenosis after radiofrequency ablation for atrial fibrillation |
| title_sort | rare case of right heart failure with the necessity for veno arterial extracorporeal membrane oxygenation following pulmonary vein stenosis after radiofrequency ablation for atrial fibrillation |
| topic | catheter ablation extracorporeal membrane oxygenation pulmonary hypertension pulmonary vein stenosis right heart failure |
| url | https://doi.org/10.1002/pul2.12189 |
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