title: A decrease in pulmonary vein diameter after radiofrequency ablation predicts the development of severe stenosis.
abstract: A decrease in ostial pulmonary vein (PV) diameter was observed in patients on the day after radiofrequency ablation of atrial fibrillation (AF). This study examined whether a relative reduction in PV diameter on day 1 (RRPVD1) after the procedure predicts the late development of severe PV stenosis (PVS). The study included 104 consecutive patients (mean age = 55 years, range 46-61, 34 women) with drug refractory AF. Pulmonary vein diameter was measured using MR angiography (MRA) on the day before and on day 1 after the ablation procedure. The MRA was repeated every 3 months after the procedure. Severe PVS was defined as a >70% diameter reduction from the initial ostial diameter. The cut-off of RRPVD1 was prespecified as 25% decrease in initial diameter. The data are presented as medians and interquartile range. A total of 357 PV were treated. The RRPVD1 was 0.0% (0.0-11.1%). Severe PVS was found in 18 PV during a follow-up of 12 months (range 6-13). The log-rank analysis confirmed a strong association between a RRPVD1 >/=25% and the development of PVS (hazard ratio: 7.1; 95% confidence interval 3.8-13.5, P < 0.0001). By multivariate Cox regression model, after adjustment of procedure variables, RRPVD1 was the strongest predictor of development of severe PVS. RRPVD1 >/=25% was a strong independent predictor of development of severe PVS.
authors.affiliation: Department of Cardiology, Kerckhoff Clinic, Bad Nauheim, Germany. a.berkowitsch@kerckhoff-klinik.de
authors.forename: Alexander
authors.initials: A
authors.lastname: Berkowitsch
authors.forename: Thomas
authors.initials: T
authors.lastname: Neumann
authors.forename: Okan
authors.initials: O
authors.lastname: Ekinci
authors.forename: Harald
authors.initials: H
authors.lastname: Greiss
authors.forename: Thorsten
authors.initials: T
authors.lastname: Dill
authors.forename: Klaus
authors.initials: K
authors.lastname: Kurzidim
authors.forename: Malte
authors.initials: M
authors.lastname: Kuniss
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Schneider
authors.forename: Heinz F
authors.initials: HF
authors.lastname: Pitschner
mesh_terms: D000368:Aged; D017115:Catheter Ablation; D003251:Constriction, Pathologic / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000175:diagnosis*; D011379:Prognosis; D011667:Pulmonary Veins / Q000473:pathology*; D012720:Severity of Illness Index; D013997:Time Factors