Author + information
- Received October 24, 2016
- Accepted November 3, 2016
- Published online February 6, 2017.
- Tom De Potter, MDa,
- Etel Silva Garcia, PhDa,
- Roel Beelen, MDb and
- Sofia Chatzikyriakou, MD, PhDa,∗ ()
- aArrhythmia Unit, Cardiovascular Center, OLV Hospital, Aalst, Belgium
- bDepartment of Cardiovascular and Thoracic Surgery, OLV Hospital, Aalst, Belgium
- ↵∗Address for correspondence:
Dr. Sofia Chatzikyriakou, Arrhythmia Unit, Cardiovascular Center, OLV Hospital, Moorselbaan 164, 9300 Aalst, Belgium.
Three years ago, a 53-year-old woman underwent radiofrequency pulmonary vein (PV) isolation for atrial fibrillation. She remained in sinus rhythm but developed progressive dyspnea over 2 years due to severe PV stenosis. Open surgical venous reconstruction was performed unsuccessfully. The patient was referred to our hospital for further intervention.
PV stenosis after radiofrequency ablation for atrial fibrillation is a serious complication, treated widely by percutaneous stenting (1). Three-dimensional (3D) rotational angiography (3DRA) guides PV isolation (2). However, we first illustrate the usefulness of 3DRA in safe and anatomically accurate PV stenting.
3DRA of the left atrium (LA) was performed (Online Videos 1 and 2). The 3D model was segmented and integrated to the 3D navigation system (Figures 1A and 1B). The 3DRA revealed severe stenosis in left superior PV, left inferior PV, and subtotal stenosis in the right superior PV, whereas the right inferior PV was relatively normal (Figure 1A). A tailored balloon-expandable stent was placed in each vein according to the 3D model integrated with live fluoroscopy (Figures 1C to 1G). Afterward, post-implantation 3DRA was performed showing patency in all veins (Figure 1H).
For supplemental videos and their legends, please see the online version of this article.
Dr. Chatzikyriakou has been supported by a fellowship grant in electrophysiology from the Hellenic Cardiological Society for the year 2016. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received October 24, 2016.
- Accepted November 3, 2016.
- American College of Cardiology Foundation
- Holmes D.R. Jr..,
- Monahan K.H.,
- Packer D.
- De Potter T.J.,
- Bardhaj G.,
- Viggiano A.,
- Morrice K.,
- Geelen P.