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A 69-year-old woman with predominant paroxysmal atrial flutter and occasional paroxysmal atrial fibrillation underwent multidetector computed tomography prior to ablation. Imaging revealed bronchial arteriovenous malformation with aneurysms near the aortic origin and pulmonary vein drainage, and hemodynamic evaluation showed a non-significant left-to-right shunt. Based on perioperative concerns, the plan was modified to perform only typical PAFL ablation, followed by uneventful 6-month outcomes and scheduled imaging surveillance.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/bronchial-arteriovenous-malformation-detection-prior-to-catheter-ablation-for-paroxysmal-atrial-flutter-and-fibrillation-case-report/460093/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/bronchial-arteriovenous-malformation-detection-prior-to-catheter-ablation-for-paroxysmal-atrial-flutter-and-fibrillation-case-report/460093.png","ImageObject",300,407,{"name":92,"@type":93},"Blitz","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was detected on multidetector computed tomography before the catheter ablation?","Question",{"text":112,"@type":113},"A bronchial arteriovenous malformation (BAVM) was detected, including a serpiginous bronchial artery draining into the right pulmonary artery and associated aneurysms.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How did the BAVM finding affect the ablation strategy?",{"text":117,"@type":113},"Perioperative concerns related to the BAVM’s location led to modifying the plan: instead of a combined procedure, only a typical PAFL ablation was performed.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the post-procedural and follow-up outcomes reported?",{"text":121,"@type":113},"The patient had an uneventful post-procedural course with no arrhythmic recurrence or BAVM-related complications at 6 months, with annual contrast-enhanced CT angiography follow-ups scheduled.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},460093,1790793344,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},24464137899374,"https://us-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","e-ISSN 1941-5923  \n© Am J Case Rep, 2025; 26: e949879 DOI: 10. 12659/AJCR.949879  \nReceived: 2025.05.18  \nAccepted: 2025.10.01  \nAvailable online: 2025.11.17  \nPublished: 2025.12.24  \nAuthors’ Contribution: Study Design A  \nData Collection B Statistical Analysis C Data Interpretation D Manuscript Preparation E Literature Search F Funds Collection G  \nABDEF  \nEF  \nBD  \nCD  \nF  \nEF  \nE  \nB  \nBF  \nAE  \nCorresponding Author: Financial support: Conflict of interest:  \n1 1  \n2 2  \n1 1  \n1 1  \n1 1  \nBronchial Arteriovenous Malformation Detection Prior to Catheter Ablation for Paroxysmal Atrial Flutter and Fibrillation: A Case Report  \nAlexandra Arvanitaki  Marios Georgios Bantidos  Theodora Zaglavara  Lydia Kalogeropoulou  Athanasios Samaras  Athina Nasoufidou  Efstratios Karagiannidis  Georgios Stavropoulos  Apostolos Tzikas  Nikolaos Fragakis   \nNikolaos Fragakis, e-mail: [fragakis.nikos@gmail.com](fragakis.nikos@gmail.com)  \nNone declared  \nNone declared  \n1 Second Department of Cardiology, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece  \n2 Department of Radiology, Interbalkan Medical Center, Thessaloniki, Greece  \nPatient: Female, 69-year-old  \nFinal Diagnosis: Bronchial arteriovenous malformation • paroxysmal atrial fibrillation • paroxysmal atrial flutter Symptoms: Palpitation  \nClinical Procedure: Catheter ablation of AF  \nSpecialty: Cardiology • Radiology  \nObjective: Rare disease  \nBackground: Catheter ablation for paroxysmal atrial flutter (PAFL) and atrial fibrillation (PAF) is a first-line treatment to maintain sinus rhythm. However, routine preprocedural imaging is not standardized, despite a high prevalence of incidental findings that may influence procedural planning. This report describes a case of a bronchial arteriovenous malformation (BAVM) detected on multidetector computed tomography prior to ablation in a patient with PAFL and PAF.  \nCase Report: A 69-year-old woman who predominantly experienced episodes of PAFL, with occasional PAF, underwent preablation multidetector computed tomography. Imaging demonstrated a serpiginous bronchial artery draining into the right pulmonary artery, with 2 aneurysms (approximately 1 cm proximal to the aortic origin and 4 cm proximal to the drainage site) in close proximity to the right pulmonary veins. Hemodynamic evaluation confirmed a non-significant left-to-right shunt, and a conservative approach was selected. Because of perioperative concerns about the BAVM’s location, the procedural plan was modified; rather than a combined procedure of pulmonary vein isolation with right isthmus ablation, only a typical PAFL ablation was performed. The patient had an uneventful post-procedural course, without arrhythmic recurrence or BAVM-related complications at 6 months. Annual follow-ups with contrast-enhanced computed tomography angiography were scheduled after joint cardiology and radiology consultation.  \nConclusions: This case highlights the importance of systematic preprocedural imaging in PAF and PAFL ablation to detect unexpected intra-or extracardiac findings, such as a BAVM, that may affect procedural strategy and require a multidisciplinary approach.  \nKeywords: Ablation Techniques • Atrial Fibrillation • Atrial Flutter • Bronchial Fistula • Computed Tomography Angiography  \nFull-text PDF: [https://www.amjcaserep.com/abstract/index/idArt/949879](https://www.amjcaserep.com/abstract/index/idArt/949879)  \n1846  —  5  35  \nPublisher’s note: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher  \nThis work is licensed under Creative Common AttributionNonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)  \ne949879-1  \nIndexed in: [PMC] [PubMed]","cbCaikYIM3opUCK3","https://ap.wps.com/l/cbCaikYIM3opUCK3","pdf",1278567,"English","# Introduction\n# Case Report\n# Conclusions","[{\"question\":\"What was detected on multidetector computed tomography before the catheter ablation?\",\"answer\":\"A bronchial arteriovenous malformation (BAVM) was detected, including a serpiginous bronchial artery draining into the right pulmonary artery and associated aneurysms.\"},{\"question\":\"How did the BAVM finding affect the ablation strategy?\",\"answer\":\"Perioperative concerns related to the BAVM’s location led to modifying the plan: instead of a combined procedure, only a typical PAFL ablation was performed.\"},{\"question\":\"What were the post-procedural and follow-up outcomes reported?\",\"answer\":\"The patient had an uneventful post-procedural course with no arrhythmic recurrence or BAVM-related complications at 6 months, with annual contrast-enhanced CT angiography follow-ups scheduled.\"}]","Bronchial Arteriovenous Malformation Detection Prior to Catheter Ablation for Paroxysmal Atrial Flutter and Fibrillation - Case Report | PDF",1790757721,15]