Incidence of Pulmonary Vein Stenosis After Radiofrequency Catheter Ablation of Atrial Fibrillation

JACC. Clinical Electrophysiology
Cas TeunissenPeter Loh

Abstract

This study aimed to determine incidence of pulmonary vein stenosis (PVS) and evaluate PVS-related symptoms. The real-life incidence of PVS after radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) is unknown. All patients who underwent RFCA of AF from 2005 to 2016 with routine pre- and post-ablation screening by magnetic resonance imaging or computed tomography were included. Primary ablation strategy was PV antrum isolation alone in all patients. PVS, defined as a significant reduction in the superoinferior or anteroposterior PV diameter, was classified as mild (30% to 50%), moderate (50% to 70%), or severe (>70%). Sufficient quality imaging of the PV anatomy before ablation and during follow-up (mean 6 ± 4 months) was performed in 976 patients (76.4% men, 59.1% paroxysmal AF). Of these patients, 306 (31.4%) showed mild stenosis, 42 (4.3%) revealed moderate stenosis, and 7 (0.7%) had a severe stenosis in at least 1 PV. Incidence of PVS fluctuated over the past decade. All severe PVS cases were likely caused by ablations being performed inside the PVs. Only 1 (0.1%) patient reported PVS-related symptoms of severe dyspnea during follow-up. Computed tomography revealed a subtotal occlusion of the left inferior PV ...Continue Reading

Citations

Nov 20, 2018·Anesthesia and Analgesia·Viviane G NasrJames A DiNardo
Aug 5, 2020·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Corrado TomasiAndrea Rubboli
Feb 9, 2020·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Hideki ItoAkihiko Usui
May 13, 2018·Circulation. Arrhythmia and Electrophysiology·Santosh K Padala, Kenneth A Ellenbogen
Oct 16, 2020·Pacing and Clinical Electrophysiology : PACE·Hiroshi MiyamaKeiichi Fukuda
Sep 23, 2020·Journal of Thoracic Imaging·Hannan SaadJeffrey Nadig

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