Pulmonary venous stenosis after treatment for atrial fibrillation

doi:10.1136/bmj.39457.764942.47

BMJ 2008;336:830-832 (12 April), doi:10.1136/bmj.39457.764942.47

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Pulmonary venous stenosis after treatment for atrial fibrillation

P Kojodjojo, specialist registrar in cardiology, T Wong, consultant cardiologist, A R Wright, consultant radiologist, O M Kon, consultant respiratory physician, W Oldfield, consultant respiratory physician, P Kanagaratnam, consultant cardiologist, D W Davies, consultant cardiologist, N S Peters, professor of cardiac electrophysiology

¹ St Mary’s Hospital, Imperial College Healthcare NHS Trust, London W2 1NY

Correspondence to: N S Peters n.peters@imperial.ac.uk

Pulmonary venous stenosis should be considered in patients presentingwith respiratory symptoms after atrial fibrillation ablation

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A 70 year old woman was referred by her general physician tothe respiratory clinic with a few days’ history of haemoptysiswithout any associated chest pain, fever, or dyspnoea. The onlymedical history of note was a successful pulmonary venous isolationprocedure for paroxysmal atrial fibrillation in the previousweek. She was a lifelong non-smoker and was previously fit andwell. Physical examination and routine blood tests were unremarkable.The electrocardiogram showed sinus rhythm. A small (2 cm) opacitywas seen on the chest radiography in the left mid-zone. Computedtomography of the thorax and abdomen showed only numerous ill-definedpatchy lesions with ground-glass shadowing in the left upperlobe, without any evidence of malignancy. Bronchoscopy showedaltered blood in the left upper lobe bronchus, and lavage specimenswere negative for malignancy and infection, including tuberculosis.She was treated empirically for an atypical pneumonia.

Haemoptysis recurred six weeks later. . . . [Full text of this article]

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