Lung Perfusion Scintigraphy in Pulmonary Vein Occlusion After Radiofrequency Ablation

We describe functional and anatomical imaging findings in an 86-year-old woman who was treated for paroxysmal atrial fibrillation 5 years ago with radiofrequency ablation. She had been symptom-free for 4 years. Five years after the ablation, she presented with exertional dyspnea of several months' duration. She had left bundle branch block and aortic insufficiency with normal ejection fraction on 2-dimensional echocardiogram, none of which explained her symptoms. A CT coronary angiogram showed no obstructive coronary artery disease: Coronary Artery Disease Reporting and Data System category 1. Complete occlusion of the left superior pulmonary vein was, however, noted at its origin. Lung perfusion scintigraphy was obtained to evaluate differential perfusion.