Ventilation/Perfusion Mismatch in Pulmonary Vein Stenosis Secondary to Atrial Fibrillation Ablation
نویسندگان
1 Tokushima University Graduate School of Health Sciences, Tokushima City, Japan
2 Department of Medical Imaging/Nuclear Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima City, Japan
3 Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima City, Japan
4 Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima City, Japan
5 Tokushima University Graduate School of Health Sciences, Tokushima City, Japan
6 Tokushima University Graduate School of Health Sciences, Tokushima City, Japan
7 Department of Radiology, Tokushima University Hospital, Tokushima City, Japan
8 Department of Radiology, Tokushima University Hospital, Tokushima City, Japan
9 Department of Radiation Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima City, Japan
10 Department of Radiology, Tokushima University Hospital, Tokushima City, Japan
11 Department of Medical Imaging/Nuclear Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima City, Japan
12 Department of Radiology, Tokushima University Hospital, Tokushima City, Japan
13 Advance Radiation Research, Education and Management Center, Tokushima University, Tokushima City, Japan
14 Tokushima University Graduate School of Health Sciences, Tokushima City, Japan
15 Department of Radiology, Tokushima University Hospital, Tokushima City, Japan
16 Department of Diagnostic Radiology, Tokushima University Graduate School of Biomedical Sciences, Tokushima City, Japan
17 Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima City, Japan
18 Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima City, Japan
doi
10.22038/aojnmb.2024.79650.1561چکیده
We present two patients with a history of paroxysmal atrial fibrillation who developed pulmonary vein stenosis (PVS) following atrial fibrillation (AF) ablation. Case 1 involved a female patient in her 50s who was asymptomatic for pulmonary symptoms but was found to have a high degree of left superior PVS 15 months after AF ablation. This was demonstrated using contrast-enhanced computed tomography (CE-CT) and supported by findings of perfusion defects on ventilation-perfusion (V/Q) scan. Case 2 was a male patient in his 60s who developed progressive left superior PVS nine months after AF ablation, evidenced by serial CE-CT and V/Q scans.PVS is a rare but well-known complication of pulmonary vein ablation for the treatment of AF that can lead to severe complications if left untreated. V/Q scans effectively assess the functional significance of PVS by detecting abnormal blood flow segments. Although a V/Q mismatch characterized by reduced perfusion defects is more commonly used in evaluating pulmonary embolism, PVS should not be disregarded as a differential diagnosis. Few studies emphasize the utility of V/Q scans in managing PVS and highlight V/Q mismatch as a notable finding. This case report aimed to highlight their significance.
