ArticleEuropean heart journal. Case reports2026
Safety of pulsed-field ablation combined with IVUS-guided pulmonary vein stenting during atrial fibrillation ablation: a case report.
Article in European heart journal. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Pulmonary vein stenosis (PVS) is an uncommon but serious complication of atrial fibrillation (AF) ablation. Angioplasty with stent implantation is the standard treatment for severe PVS; however, restenosis and re-occlusion remain frequent challenges. Pulsed-field ablation (PFA), a novel non-thermal ablation modality for pulmonary vein isolation, causes minimal structural damage and may therefore be particularly suitable and safer for complex redo procedures involving previously stenosed pulmonary veins. Case summary: A 50-year-old man underwent pulmonary vein isolation using radiofrequency in February 2023. A few months later, he developed breathlessness, and a computed tomography scan showed a stenosis of the left inferior pulmonary vein (LIPV) and normal coronary arteries. He also had recurrent arrhythmias. In March 2024, with a cerebral protection device Discussion: This case highlights the complexity of managing AF ablation-related PVS and underscores the role of IVUS in guiding revascularization. It also demonstrates the safety of PFA (in particular Varipulse™, J&J MedTech) near a stented pulmonary vein, achieving effective electrical isolation with minimal additional structural injury.
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