Hemoptysis and Bloody Pleural Effusion in Atrial Fibrillation Patients Post-Radiofrequency Ablation: two Case Report and Mechanistic Discussion

Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. Developing pulmonary vein stenosis (PVS) after surgery can lead to serious symptoms, including chest pain, coughing up blood, and bloody pleural effusion. This study reviews two patients who developed PVS after AF radiofrequency ablation. It examines their clinical manifestations and the effectiveness of percutaneous pulmonary vein stenting. Through case analysis and literature review, we describe the clinical courses of two patients. Case 1, a 66-year-old male, presented with chest pain and bloody pleural effusion and showed significant improvement after pulmonary vein stenting. Case 2, a 52-year-old male, experienced recurrent coughing up blood, with symptoms that completely resolved after stenting. The findings suggest that percutaneous pulmonary vein stenting is very effective in alleviating symptoms associated with pulmonary vein stenosis. Despite the limited sample size, the results indicate that this treatment method offers an effective management option for AF patients. It highlights the need for individualized treatment and further exploration of the pathological mechanisms linking AF and PVS. Future larger-scale prospective studies are needed to verify the long-term safety and efficacy of this method to optimize clinical management strategies.