Key result
Pulmonary vein isolation using a multielectrode ablation catheter resulted in moderate pulmonary vein narrowing in 78% of patients and severe narrowing in 15% at 3 months.
Why the study?
Does pulmonary vein isolation using a multi-electrode ablation catheter cause pulmonary vein narrowing?
Observational (n=50)
Does pulmonary vein isolation using a multi-electrode ablation catheter cause pulmonary vein narrowing?
The use of a multi-electrode ablation catheter with duty-cycled phased radiofrequency energy for pulmonary vein isolation is associated with a high rate of moderate to severe pulmonary vein narrowing at 3 months.
May warrant caution and follow-up imaging with this catheter; leaves open long-term clinical impact versus other PVI technologies.
BACKGROUND: The risk of pulmonary vein narrowing (PVN) after pulmonary vein isolation, using a novel multi-electrode ablation catheter, is unknown. METHODS AND 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.
No takes yet. Share an insight, caveat, or question.
Greef et al. (2011) conducted an observational in Pulmonary vein isolation (n=50). Pulmonary vein isolation using a multi-electrode ablation catheter vs. Baseline was evaluated on Pulmonary vein narrowing (PVN). Pulmonary vein isolation using a multielectrode ablation catheter resulted in moderate pulmonary vein narrowing in 78% of patients and severe narrowing in 15% at 3 months.