No severe pulmonary vein stenosis after extensive encircling pulmonary vein isolation: 12-month follow-up with 3D computed tomography.
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.
Department of Cardiology, Musashino Red Cross Hospital, 1-26-1 Sakai-Minami, Musashino, Tokyo 180-8610, Japan. s-maeda@ja2.so-net.ne.jp
Shingo
S
Maeda
Yoshito
Y
Iesaka
Kiyoshi
K
Otomo
Kikuya
K
Uno
Yasutoshi
Y
Nagata
Kenji
K
Suzuki
Hitoshi
H
Hachiya
Masahiko
M
Goya
Atsushi
A
Takahashi
Hideomi
H
Fujiwara
Mitsuaki
M
Isobe
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D016009:Chi-Square Distribution; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods*; D011237:Predictive Value of Tests; D011667:Pulmonary Veins / Q000000981:diagnostic imaging / Q000601:surgery*; D011668:Pulmonary Veno-Occlusive Disease / Q000000981:diagnostic imaging* / Q000209:etiology; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome