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European Heart Journal Advance Access originally published online on May 23, 2005
European Heart Journal 2005 26(14):1355-1357; doi:10.1093/eurheartj/ehi313
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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oupjournals.org

Pulmonary vein stenosis: still the Achilles heel of ablation for atrial fibrillation?

Helmut Pürerfellner*

Department of Internal Medicine/Cardiology, Public Hospital Elisabethinen, Academic Teaching Hospital, Fadingerstrasse 1, A-4010 Linz, Austria

* Corresponding author. Tel: +43 732 7676 0; fax: +43 732 7676 2106. E-mail address: helmut.puererfellner@elisabethinen.or.at

This editorial refers to ‘Pulmonary haemodynamics at rest and during exercise in patients with significant pulmonary vein stenosis after radiofrequency catheter ablation for drug resistant atrial fibrillation'{dagger} by T. Arentz et al., on page 1410

The first 10% of the full text of this article appears below.

Atrial fibrillation (AF) can be eliminated by (i) targeted delivery to focal ‘sites’ within the pulmonary vein (PV), by (ii) PV isolation through circumferential or segmental ablation at the venoatrial junction, or by (iii) electrical isolation from the left atrium (LA) outside the PV ostia. PV stenosis develops in 1–10% of patients undergoing ablation. So far, the clinical presentation, investigation, management, and outcome of this disease have been incompletely reported.

Understanding PV anatomy is crucial both for PV ablation and for prevention of PV stenosis. Using magnetic resonance (MR) scanning, Cato et al.1 have reported that 38% of patients exhibit a variant anatomy (short or long common left trunk, right middle or right upper PV). In addition, very close proximity between the ostia of the right and the left PVs was observed. The diameters of the four regular PVs did not differ significantly, but PV and LA seemed larger . . . [Full Text of this Article]


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Related articles in EHJ:

Pulmonary haemodynamics at rest and during exercise in patients with significant pulmonary vein stenosis after radiofrequency catheter ablation for drug resistant atrial fibrillation
Thomas Arentz, Reinhold Weber, Nikolaus Jander, Gerd Bürkle, Jörg von Rosenthal, Thomas Blum, Jochem Stockinger, Laurent Haegeli, Franz Josef Neumann, and Dietrich Kalusche
EHJ 2005 26: 1410-1414. [Abstract] [Full Text]