No severe pulmonary vein stenosis after extensive encircling pulmonary vein isolation: 12-month follow-up with 3D computed tomography.

Abstract

Few studies have explored the utility of local electrogram-guided extensive encircling pulmonary vein isolation (EEPVI) by analyzing the pulmonary vein (PV) anatomy and occurrence of stenosis using multidetector computed tomography (MDCT). One hundred seventy-six paroxysmal atrial fibrillation (AF) patients underwent EEPVI with a double lasso technique. MDCT was performed in all patients before and at 3, 6 and 12 months after the ablation procedures to screen for PV stenosis. PV stenosis was defined as a >30% reduction in its diameter. A total of 700 PVs were analyzed. PV stenosis was observed in 15 of 700 PVs (2.1%). All stenoses were mild (mean 34.5 ± 3.3%). They were all asymptomatic, and none required treatment. After 12 months of follow-up, the PV narrowing regressed significantly compared with that at 3 months in the patients with PV stenosis (34.5 ± 3 to 30.4 ± 5%, P < 0.05). The remaining PVs exhibited a stable anatomy, and there was no significant progression of the PV narrowing. The results of this study demonstrated that detectable PV stenosis occurred in 2.1% of the PVs, and all stenoses were mild. Moreover, a significant regression of the PV narrowing was observed after 12-months of follow-up. This indicates that the local electrocardiogram-guided EEPVI was relatively safe regarding severe PV stenosis.

• Authors: Shingo Maeda, Yoshito Iesaka, Kiyoshi Otomo, Kikuya Uno, Yasutoshi Nagata, Kenji Suzuki, Hitoshi Hachiya, Masahiko Goya, Atsushi Takahashi, Hideomi Fujiwara, Mitsuaki Isobe
• Journal: Heart and vessels (Heart Vessels) Vol. 26 Issue 4 Pg. 440-8 (Jul 2011) ISSN: 1615-2573 [Electronic] Japan
• PMID: 21132307 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Atrial Fibrillation (diagnostic imaging, surgery)
• Catheter Ablation (adverse effects, methods)
• Chi-Square Distribution
• Electrophysiologic Techniques, Cardiac
• Female
• Humans
• Japan
• Male
• Middle Aged
• Phlebography (methods)
• Predictive Value of Tests
• Pulmonary Veins (diagnostic imaging, surgery)
• Pulmonary Veno-Occlusive Disease (diagnostic imaging, etiology)
• Risk Assessment
• Risk Factors
• Severity of Illness Index
• Time Factors
• Tomography, X-Ray Computed
• Treatment Outcome