No severe pulmonary vein stenosis after extensive encircling pulmonary vein isolation: 12-month follow-up with 3D computed tomography

作者：Maeda Shingo^*; Iesaka Yoshito; Otomo Kiyoshi; Uno Kikuya; Nagata Yasutoshi; Suzuki Kenji; Hachiya Hitoshi; Goya Masahiko; Takahashi Atsushi; Fujiwara Hideomi; Isobe Mitsuaki

来源：Heart and Vessels, 2011, 26(4): 440-448.

DOI：10.1007/s00380-010-0073-5

• Atrial fibrillation
• Ablation
• Extensive encircling pulmonary vein isolation
• Pulmonary vein stenosis
• Multidetector computed tomography

Few studies have explored the utility of local electrogram-guided extensive encircling pulmonary vein isolation (EEPVI) by analyzing the pulmonary vein (PV) anatomy and occurrence of stenosis using multidetector computed tomography (MDCT). One hundred seventy-six paroxysmal atrial fibrillation (AF) patients underwent EEPVI with a double lasso technique. MDCT was performed in all patients before and at 3, 6 and 12 months after the ablation procedures to screen for PV stenosis. PV stenosis was defined as a > 30% reduction in its diameter. A total of 700 PVs were analyzed. PV stenosis was observed in 15 of 700 PVs (2.1%). All stenoses were mild (mean 34.5 +/- A 3.3%). They were all asymptomatic, and none required treatment. After 12 months of follow-up, the PV narrowing regressed significantly compared with that at 3 months in the patients with PV stenosis (34.5 +/- A 3 to 30.4 +/- A 5%, P < 0.05). The remaining PVs exhibited a stable anatomy, and there was no significant progression of the PV narrowing. The results of this study demonstrated that detectable PV stenosis occurred in 2.1% of the PVs, and all stenoses were mild. Moreover, a significant regression of the PV narrowing was observed after 12-months of follow-up. This indicates that the local electrocardiogram-guided EEPVI was relatively safe regarding severe PV stenosis.

• 出版日期2011-7