A decrease in pulmonary vein diameter after radiofrequency ablation predicts the development of severe stenosis.

Alexander Berkowitsch; Thomas Neumann; Okan Ekinci; Harald Greiss; Thorsten Dill; Klaus Kurzidim; Malte Kuniss; Hans J Schneider; Heinz F Pitschner

doi:10.1111/j.1540-8159.2005.00018.x

PubMed · 15683534

A decrease in pulmonary vein diameter after radiofrequency ablation predicts the development of severe stenosis.

Alexander Berkowitsch·Thomas Neumann·Okan Ekinci·Harald Greiss·Thorsten Dill·Klaus Kurzidim·Malte Kuniss·Hans J Schneider·Heinz F Pitschner

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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.

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Aged Catheter Ablation Constriction, Pathologic Female Follow-Up Studies Humans Male Middle Aged Multivariate Analysis Postoperative Complications Prognosis Pulmonary Veins Severity of Illness Index Time Factors Journal Article

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Alexander Berkowitsch, Thomas Neumann, Okan Ekinci, Harald Greiss, Thorsten Dill, Klaus Kurzidim, Malte Kuniss, Hans J Schneider, Heinz F Pitschner. 2005. A decrease in pulmonary vein diameter after radiofrequency ablation predicts the development of severe stenosis.. https://doi.org/10.1111/j.1540-8159.2005.00018.x

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