Non-interventional Management of Symptomatic Pulmonary Vein Occlusion after Radiofrequency Ablation for Atrial Fibrillation.

Pulmonary vein occlusion (PVO) after atrial fibrillation ablation is often highly symptomatic. In cases with a clear target, balloon angioplasty and stenting can be successful. In the absence of such a target, surgical lobectomy has been reported as a treatment option, but the natural history of physiological adaptation may outweigh the risks of invasive therapies and a non-invasive strategy is valid in these situations. We present a case of highly symptomatic PVO managed non-invasively, with complete symptom resolution and return to high-intensity exercise. Catheter intervention may not always be possible in the absence of a target vessel, and lobectomy may not be necessary to manage PVO.