title: Pulmonary vein stenosis after catheter ablation: electroporation versus radiofrequency.
abstract: BACKGROUND
  Radiofrequency ablation inside pulmonary vein (PV) ostia can cause PV stenosis. A novel alternative method of ablation is irreversible electroporation, but the long-term response of PVs to electroporation ablation is unknown.
  
  
  RESULTS
  In ten 6-month-old pigs (60-75 kg), the response of PVs to circular electroporation and radiofrequency ablation was compared. Ten consecutive, nonarcing, electroporation applications of 200 J were delivered 5 to 10 mm inside 1 of the 2 main PVs, using a custom-deflectable, 18-mm circular decapolar catheter. Inside the other PV, circular radiofrequency ablation was performed using 30 W radiofrequency applications via an irrigated 4-mm ablation catheter. PV angiograms were made before ablation, immediately after ablation, and after 3-month survival. PV diameters and heart size were measured. With electroporation ablation, PV ostial diameter decreased 11±10% directly after ablation, but had increased 19±11% after 3 months. With radiofrequency ablation, PV ostial diameter decreased 23±15% directly after ablation and remained 7±17% smaller after 3 months compared with preablation diameter despite a 21±7% increase in heart size during aging from 6 to 9 months.
  
  
  CONCLUSIONS
  In this porcine model, multiple circumferential 200-J electroporation applications inside the PV ostia do not affect PV diameter at 3-month follow-up. Radiofrequency ablation inside PV ostia causes considerable PV stenosis directly after ablation, which persists after 3 months.
authors: From the Departments of Cardiology (V.J.H.M.v.D., K.G.E.J.N., H.v.W., B.C.d.P., P.A.F.M.D., F.H.M.W.) and Pathology (A.V.), University Medical Center, Utrecht, The Netherlands; and Department of Rhythmology, Alfried Krupp Hospital, Essen, Germany (K.G.E.J.N.). vjhmvandriel@gmail.com.
authors: Vincent J H M
authors: VJ
authors: van Driel
authors: From the Departments of Cardiology (V.J.H.M.v.D., K.G.E.J.N., H.v.W., B.C.d.P., P.A.F.M.D., F.H.M.W.) and Pathology (A.V.), University Medical Center, Utrecht, The Netherlands; and Department of Rhythmology, Alfried Krupp Hospital, Essen, Germany (K.G.E.J.N.).
authors: Kars G E J
authors: KG
authors: Neven
authors: From the Departments of Cardiology (V.J.H.M.v.D., K.G.E.J.N., H.v.W., B.C.d.P., P.A.F.M.D., F.H.M.W.) and Pathology (A.V.), University Medical Center, Utrecht, The Netherlands; and Department of Rhythmology, Alfried Krupp Hospital, Essen, Germany (K.G.E.J.N.).
authors: Harry
authors: H
authors: van Wessel
authors: From the Departments of Cardiology (V.J.H.M.v.D., K.G.E.J.N., H.v.W., B.C.d.P., P.A.F.M.D., F.H.M.W.) and Pathology (A.V.), University Medical Center, Utrecht, The Netherlands; and Department of Rhythmology, Alfried Krupp Hospital, Essen, Germany (K.G.E.J.N.).
authors: Bastiaan C
authors: BC
authors: du Pré
authors: From the Departments of Cardiology (V.J.H.M.v.D., K.G.E.J.N., H.v.W., B.C.d.P., P.A.F.M.D., F.H.M.W.) and Pathology (A.V.), University Medical Center, Utrecht, The Netherlands; and Department of Rhythmology, Alfried Krupp Hospital, Essen, Germany (K.G.E.J.N.).
authors: Aryan
authors: A
authors: Vink
authors: From the Departments of Cardiology (V.J.H.M.v.D., K.G.E.J.N., H.v.W., B.C.d.P., P.A.F.M.D., F.H.M.W.) and Pathology (A.V.), University Medical Center, Utrecht, The Netherlands; and Department of Rhythmology, Alfried Krupp Hospital, Essen, Germany (K.G.E.J.N.).
authors: Pieter A F M
authors: PA
authors: Doevendans
authors: From the Departments of Cardiology (V.J.H.M.v.D., K.G.E.J.N., H.v.W., B.C.d.P., P.A.F.M.D., F.H.M.W.) and Pathology (A.V.), University Medical Center, Utrecht, The Netherlands; and Department of Rhythmology, Alfried Krupp Hospital, Essen, Germany (K.G.E.J.N.).
authors: Fred H M
authors: FH
authors: Wittkampf
mesh_terms: D000818:Animals; D062906:Cardiac Catheters; D017115:Catheter Ablation / Q000009:adverse effects* / Q000295:instrumentation; D018274:Electroporation / Q000295:instrumentation; D023421:Models, Animal; D010690:Phlebography; D011666:Pulmonary Valve Stenosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D011667:Pulmonary Veins / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D012307:Risk Factors; D013552:Swine; D013997:Time Factors
keywords: catheter ablation; complications; electroporation; pulmonary veins; radiofrequency