A Case of Paroxysmal Atrial Fibrillation Treated by Catheter Ablation after Lung Resection Kiyonari Matsuo 1 , Hirokazu Shiraishi 1 , Akira Kuroyanagi 1 , Takeshi Shirayama 1 , Takeshi Nakamura 1 , Tetsuhiro Yamano 1 , Akiyoshi Matsumuro 1 , Takahisa Sawada 1 , Hiroaki Matsubara 1 1Department of Cardiology, Kyoto Prefectural University of Medicine Keyword: 肺切除 , 発作性心房細動 , 肺静脈隔離術 , lung resection , paroxysmal atrial fibrillation , catheter ablation pp.539-545
Published Date 2012/5/15
DOI https://doi.org/10.11477/mf.1404101965
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 A 70-year-old male complained of palpitation due to paroxysmal atrial fibrillation(AF), that appeared 2 days after right upper lung cancer resection in March, 2009. Anti-arrhythmic agents being ineffective, we performed pulmonary vein isolation(PVI)in July,2010. AF relapsed on the 45th day after catheter ablation and we performed the second ablation in October, 2010. Bilateral additional ablation was needed, because of the re-connection between the left atrium and the pulmonary vein. We started PVI on the left side during AF, but AF did not terminate after the completion of PVI. However, during PVI on the right side, AF altered to atrial tachycardia and converted to sinus rhythm. After the second session, AF attack was free without anti-arrhythmic agents for one year.

 The AF in this case was related with the right pulmonary vein, because of the findings of catheter ablation. AF might be caused by inflammation or mechanical stress of the right pulmonary vein after right lung resection.

 In the previous reports, AF occurred in 8-42% patients after lung cancer resection and it was an important issue, because its occurrence was associated with longer hospital stay and higher cost and AF might herald other serious complications. The cause of post-operative AF was unclear, but this case suggested that pulmonary vein resection itself was a cause of AF.

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