Introduction: Acquired pulmonary vein (PV) stenosis is a well-known complication following catheter ablation of atrial fibrillation (AF). However, the details of congenital PV stenosis have not been reported in patients who underwent catheter ablation of AF.
Methods and results: A total of 178 patients (110 men, age: 54 +/- 11 years) with drug-refractory AF received MRA or multidetector CT (MDCT) before ablation for delineation of PV morphologies. Five PVs in 5 patients (2.8%) showed at least 50% stenosis before ablation. We demonstrated two types of preexisting PV stenosis. Type I is the external compression of PV by the descending aorta, observed in LIPV of the three patients. Type II is the focal narrowing of PV, observed in RSPV of the two patients.
Conclusion: Preexisting stenosis of PV may be a consequence of congenital focal narrowing or external compression by the adjacent structures. Detection of this condition by 3D CT or MRA before catheter ablation can provide information for planning of ablation strategy and prevent misdiagnosis of ablation-related PV stenosis.