title: Prevalence, characteristics, and predictors of pulmonary vein narrowing after isolation using the pulmonary vein ablation catheter.
abstract: BACKGROUND
  The risk of pulmonary vein narrowing (PVN) after pulmonary vein isolation, using a novel multi-electrode ablation catheter, is unknown.
  
  
  RESULTS
  Left atrial volume and PV diameters were compared by computed tomography (CT) before and 3 months after pulmonary vein isolation using duty-cycled phased radio frequency energy (2:1 or 4:1 bipolar/unipolar ratio) in 50 patients. Pulmonary vein diameter was measured in a coronal and axial view at 3 levels (A, ostium; B, 1 cm more distal; C, 2 cm more distal). Moderate PVN was defined as a pulmonary vein diameter reduction of 25 to 50%, and severe PVN as >50%. Left atrial volume decreased by 12±12% (P<0.01). Axial pulmonary vein diameter shortened by a median of 16% (interquartile range [IQR] 28 to 5%), 13% (IQR 25 to 5%), and 9% (IQR 21 to -3%) at level A, B, and C, respectively (P<0.01 for all); coronal pulmonary vein diameter decreased by a median of 16% (IQR 24 to 7%), 11% (IQR 21 to 4%), and 8% (IQR 18 to -2%; P<0.01 for all). Moderate PVN occurred in 30% of the PVs, in 78% of the patients; severe PVN occurred in 4% of the PVs, in 15% of the patients. PV diameter reduction was not related to changes in left atrial volume.
  
  
  CONCLUSIONS
  Isolation of the pulmonary veins using a multielectrode ablation catheter and duty cycled phased radiofrequency energy delivery results in a consistent moderate reduction of the PV diameters predominantly at the ostium. Severe PVN in 15% of patients raises concerns about the risk for clinical PV stenosis.
authors: Department of Cardiology, Cardiovascular Institute Middelheim, Antwerp, Belgium. yvesdgr@gmail.com
authors: Yves
authors: Y
authors: De Greef
authors: Rene
authors: R
authors: Tavernier
authors: Steven
authors: S
authors: Raeymaeckers
authors: Bruno
authors: B
authors: Schwagten
authors: Didier
authors: D
authors: Desurgeloose
authors: Gilles
authors: G
authors: De Keulenaer
authors: Dirk
authors: D
authors: Stockman
authors: Marc
authors: M
authors: De Buyzere
authors: Mattias
authors: M
authors: Duytschaever
mesh_terms: D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D001530:Belgium / Q000453:epidemiology; D017115:Catheter Ablation / Q000009:adverse effects*; D004562:Electrocardiography; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D011183:Postoperative Complications; D015995:Prevalence; D011379:Prognosis; D011667:Pulmonary Veins / Q000601:surgery*; D011668:Pulmonary Veno-Occlusive Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D014057:Tomography, X-Ray Computed