The incidence, diagnosis, and management of pulmonary vein stenosis as a complication of atrial fibrillation ablation

Purpose Pulmonary vein isolation (PVI) during ablation of atrial fibrillation (AF) is associated with pulmonary vein stenosis (PVS). Although the reported incidence of PVS has fallen in recent years, the precise rate of PVS is unknown. Coherent guidelines for screening and treatment of PVS are not established. We reviewed literature to investigate the incidence, diagnosis, and management of PVS as a complication of PVI. Methods We reviewed 41 manuscripts that described a total of 4,615 subjects (median, 84 subjects/study). Results The incidence of PVS after PVI reported in literature from 1999 to 2004 ranges from 0 to 44 % (mean, 6.3 %; median, 5.4 %), whereas studies after 2004 report an incidence of 0–19 % (mean, 2 %; median, 3.1 %; p