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Matthew C. Hyman et al. JACEP 2016;j.jacep.2016.09.004
Multimodality Imaging Facilitates Successful Pulmonary Vein Stenting (A) The left atrial electroanatomic map from the initial catheter ablation shows the presence of 4 pulmonary veins and the ablation lesion set (red spheres). Contrast-enhanced computed tomography (B) and follow-up left atrial electroanatomic mapping (C) later demonstrated total occlusion (red arrows) of the left superior pulmonary vein (LSPV). A combination of electroanatomic localization with an ablation catheter (D), fluoroscopy with the circular mapping catheter positioned in the right superior pulmonary vein and a decapolar catheter within the coronary sinus (E), and intracardiac echocardiography (F) were used to position the guide catheter during cannulation of the occluded pulmonary vein. A stent (blue arrows) was positioned at the LSPV ostium and inflated under fluoroscopic (G) and intracardiac echocardiography (H) guidance. Doppler peak flow velocity demonstrated restoration of normal peak velocities within the LSPV (I), similar to the nonstenosed left inferior pulmonary vein (LIPV) (J). Matthew C. Hyman et al. JACEP 2016;j.jacep American College of Cardiology Foundation
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