Background-This report describes the complication of pulmonary vein st
enosis with resultant severe pulmonary hypertension that developed in
2 patients after successful catheter ablation of chronic atrial fibril
lation. Methods and Results-Three months after successful catheter abl
ation of atrial fibrillation, both patients developed progressive dysp
nea and pulmonary hypertension. Both were found to have severe stenosi
s of all 4 pulmonary veins near the junction with the left atrium. Bal
loon dilation of the stenotic pulmonary veins was performed in these p
atients, with improvement in dyspnea and pulmonary hypertension. Concl
usions-The complication of pulmonary vein stenosis is potentially life
-threatening, and the application of radiofrequency current within the
pulmonary veins with standard catheter technology should be avoided.
This complication can be treated with balloon dilation, although the l
ong-term course is unknown.