Key result
Radiofrequency catheter ablation for atrial fibrillation resulted in pulmonary vein stenosis in 2.44% of patients, with symptoms improving after stent implantation despite a risk of restenosis.
Why the study?
Pulmonary vein stenosis is a serious complication in patients with AF receiving radiofrequency catheter ablation, prompting examination of clinical characteristics associated with its occurrence.
What are the clinical characteristics and outcomes of pulmonary vein stenosis following radiofrequency catheter ablation in patients with atrial fibrillation?
Observational (n=205)
What are the clinical characteristics and outcomes of pulmonary vein stenosis following radiofrequency catheter ablation in patients with atrial fibrillation?
Pulmonary vein stenosis is a rare (2.44%) but serious complication of radiofrequency catheter ablation for atrial fibrillation that can be effectively treated with stenting, though restenosis remains a risk.
Post-ablation PVS warrants vigilance with stenting as a symptomatic option; this Level 3 cohort leaves open long-term durability and management.
OBJECTIVE: Pulmonary vein stenosis (PVS) is a serious complication in patients with atrial fibrillation (AF) receiving radiofrequency catheter ablation (RFCA). We therefore examined these patients' clinical characteristics in relation to PVS occurrence. METHOD: We retrospectively analyzed the clinical symptoms, diagnostic procedures, and treatment strategies in patients with AF who developed PVS after RFCA. RESULTS: Among 205 patients with AF who underwent RFCA, five (2.44%) developed PVS (all men; age 44-64 years; AF history 12-60 months; 2 paroxysmal AF, 3 persistent AF). One patient underwent two RFCA sessions and the others received one. The time to PVS diagnosed by pulmonary vein computed tomography angiography (CTA) was 3 to 21 months. PVS symptoms included dyspnea and hemoptysis. Nine pulmonary veins developed PVS. Single mild PVS occurred in two asymptomatic patients and multiple PVS or single severe PVS in three symptomatic patients who underwent pulmonary vein angiography and stent placement. Symptoms in the three patients significantly improved after stent implantation; however, stent restenosis occurred 1 year later in one case. CONCLUSION: PVS is a rare complication of RFCA for AF that can be diagnosed by CTA. Pulmonary vein stent implantation can remarkably improve the symptoms, but stent restenosis may occur.
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Xu et al. (2019) conducted an observational in Atrial fibrillation (n=205). Radiofrequency catheter ablation was evaluated on Pulmonary vein stenosis (PVS). Radiofrequency catheter ablation for atrial fibrillation resulted in pulmonary vein stenosis in 2.44% of patients, with symptoms improving after stent implantation despite a risk of restenosis.
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