A decrease in pulmonary vein diameter after radiofrequency ablation predicts the development of severe stenosis.
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.
Berkowitsch
Alexander
A
Department of Cardiology, Kerckhoff Clinic, Bad Nauheim, Germany. a.berkowitsch@kerckhoff-klinik.de
Neumann
Thomas
T
Ekinci
Okan
O
Greiss
Harald
H
Dill
Thorsten
T
Kurzidim
Klaus
K
Kuniss
Malte
M
Schneider
Hans J
HJ
Pitschner
Heinz F
HF
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