Pulmonary Vein Isolation for Atrial Fibrillation in the Postpneumonectomy Population: A Feasibility, Safety, and Outcomes Study. (26th February 2015)

• Record Type: Journal Article
• Authors: KANMANTHAREDDY, ARUN; VALLAKATI, AJAY; REDDY YERUVA, MADHU; DIXIT, SANJAY; DI BIASE, LUIGI; MANSOUR, MOUSSA; BOOLANI, HEMANT; GUNDA, SAMPATH; BUNCH, T. JARED; DAY, JOHN D.; RUSKIN, JEREMY N.; BUDDAM, AVANIJA; KORIPALLI, SANDEEP; BOMMANA, SUDHARANI; NATALE, ANDREA; LAKKIREDDY, DHANUNJAYA
• Is Part Of: Journal of cardiovascular electrophysiology. Volume 26:Number 4(2015:Apr.)
• Page Start: 385
• Page End: 389
• Publication Date: 2015-02-26
• Subjects: Blood vessels -- Physiology -- Periodicals; Electrophysiology -- Periodicals; Heart -- Physiology -- Periodicals; 612.1
• DOI: 10.1111/jce.12619
• Languages: English
• ISSNs: 1045-3873

Abstract

<abstract abstract-type="main"> <title>AF Ablation in Pulmonary Vein Stumps</title> <sec id="jce12619-sec-0010" sec-type="section"> <title>Background</title> <p>Pulmonary vein isolation (PVI) of the remnant pulmonary vein (PV) stumps in pneumonectomy patients has not been well characterized.</p> </sec> <sec id="jce12619-sec-0020" sec-type="section"> <title>Methods</title> <p>This is a multicenter observational study of patients with a remnant PV stump after pneumonectomy. Consecutive patients with a history of pneumonectomy and who had undergone RF ablation for drug refractory AF were identified from the AF database at the participating institutions.</p> </sec> <sec id="jce12619-sec-0030" sec-type="section"> <title>Results</title> <p>There were 15 patients in whom pneumonectomy was performed, for resection of tumors in 10, infection in 4, and bullae in 1 patient and who underwent RF ablation for AF. The mean age was 63 ± 7 years. The stumps were from the right lower PV in 5, left upper PV in 5, left lower PV in 3, and right upper PV in 2 patients. All the PV stumps were electrically active with PV potentials and 9 (60%) of them had triggered activity. PVI was performed in 14 and focal isolation in 1 patient. At 1‐year follow‐up, 80% were free of AF, off of antiarrhythmic medications.</p> </sec> <sec id="jce12619-sec-0040" sec-type="section"> <title>Conclusion</title> <p>PV stumps in AF patients with previous pneumonectomy are electrically active and are frequently the sites of active firing. Isolation of these PV stumps can be accomplished safely and effectively using catheter ablation with no practical concern for PV stenosis or compromising PV stump integrity.</p> </sec> </abstract>