Pneumotox » Drug » Catheter ablation for atrial fibrillation

Catheter ablation for atrial fibrillation

Cryo- or radiofrequency ablation near pulmonary veins ostia for the treatment of supraventricular arrhythmias. See also under 'electrophysiologic procedures'. PMID: 24268510, 26025160, 26080278, 30918669, 31144560

Last update : 13/02/2022

I.y Progression, acceleration or exacerbation of preexisting ILD/fibrosis

I.ao Pulmonary infiltrates

II.b ARDS - Acute lung injury

III.a Alveolar hemorrhage (AH), diffuse AH (DAH)

III.c Hemoptysis

III.h Major/massive hemoptysis

III.l Alveolar hemorrhage, localized (e.g. lobar)

IV.z Bronchial wall erosion/hematoma

IV.ah Bronchopericardial fistula

V.a Pleural effusion (uni- or bilateral) (can accompany DI-LDs)

V.e Hemothorax - Serosanguineous pleural effusion

V.n Hemopericardium - Bloody pericardial effusion

V.af Pneumopericardium

VI.b Pulmonary arterial hypertension

VI.o Air/gas embolism

VI.z Pulmonary vein stenosis

VI.ac Pulmonary infarction

VI.ae Pulmonary vein perforation/rupture

VII.d Fibrosing mediastinitis

VII.g Hemomediastinum - Mediastinal hematoma

VII.h Pneumomediastinum

VIII.b Hematoma of/around central airway wall potentially causing UAO

VIII.h Vocal cord dysfunction, adduction, closure, injury

VIII.j Laryngeal disorder-Laryngeal nerve palsy (dysphonia, hoarseness)

IX.j Phrenic nerve injury - Hemi- or bilateral diaphragmatic paralysis

IX.n Vagal nerve injury (may cause GE reflux/GERD)

XI.b Chest pain (acute or subacute), lone or prominent

XI.h Esophageal pathology (erosion, ulcer, tear, rupture, fistula)

XI.k Esophageal hematoma (may cause chest pain and/or tracheal compression)

XI.bl Pericardial-esophageal fistula

XII.c Pericardial effusion (w/wo tamponade)

XII.g Coronary artery disease (acute) - Myocardial ischemia/infarction

XII.af Coronary vasospasm - Vasospastic angina

XII.aw Postcardiac/-cardiotomy injury (PCIS-Dressler syndrome)

XII.bd Perforation of the heart - Cardiac rupture

XII.bg Atrio-esophageal fistula

XII.bh Atrial septal defect, acquired

XII.bk Pulmonary vein thrombosis

XV.g Path: Alveolar hemorrhage (see also IIIa)

XV.ah Path: Pulmonary congestion

XV.ak Path: Pulmonary veno-occlusive disease (PVOD)

XV.cx Path: Pulmonary vein stenosis

XVI.b Imaging: Ground-glass opacities (GGO) / shadowing

XVI.l Imaging: Peribronchovascular areas of consolidation

XVI.bg Imaging: Pulmonary vein stenosis

XVI.bo Imaging: Localized calcification of pulmonary vein or veins

XVII.a Respiratory tract infection incl. pneumonia

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

Clinical, imaging, BAL, pathological pattern consistent with the specific drug

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

More detailed checklist

The Drug-Induced Respiratory Disease Website

Philippe Camus, M.D.

Dijon, France