Author + information
- Received February 5, 2018
- Revision received April 2, 2018
- Accepted May 8, 2018
- Published online August 20, 2018.
- Katharina Schoene, MDa,b,∗ (, )
- Arash Arya, MDa,
- Cosima Jahnke, MDa,
- Ingo Paetsch, MDa,
- Sotirios Nedios, MDa,
- Sebastian Hilbert, MDa,
- Andreas Bollmann, MD, PhDa,
- Gerhard Hindricks, MDa,b and
- Philipp Sommer, MDa
- aDepartment of Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany
- bLeipzig Heart Institute, Leipzig, Germany
- ↵∗Address for correspondence:
Dr. Katharina Schoene, University of Leipzig, Heart Center, Department of Electrophysiology, Struempellstrasse 39, 04289 Leipzig, Germany.
Objectives The aim of the present study was to analyze and report a single-center experience with catheter interventional treatment of radiofrequency-induced pulmonary vein stenosis (PVS) following atrial fibrillation (AF) ablation.
Background Catheter interventional treatment of radiofrequency-induced PVS following AF ablation remains a challenging field because of a lack of randomized data and treatment guidelines.
Methods All patients at a single center who underwent catheter interventional treatment for radiofrequency-induced PVS were retrospectively assessed.
Results From January 2004 to September 2017, the total rate of PVS following interventional AF ablation was 0.78% (87 of 11,103). Thirty-nine patients with PVS were treated with 84 catheter interventions: 68 (81%) with percutaneous transluminal balloon angioplasty (PTA) and 16 (19%) with stent implantation. The distribution of stent type was 3 drug-eluting stents (19%) and 13 bare-metal stents (81%). The overall restenosis rate was 53% after PTA versus 19% after stent implantation (p = 0.007) after a median follow-up period of 6 months (interquartile range: 3 to 55 months). The total complication rate for PTA was 10% versus 13% for stenting (p = NS).
Conclusions This study demonstrates significantly better outcomes in terms of restenosis after stent implantation versus PTA only, with comparable complication rates for these 2 options of interventional treatment of radiofrequency-induced PVS. In summary, despite the lack of randomized studies, the present data and currently available published studies seem to favor stent implantation as a first-line therapy in patients with radiofrequency-induced severe PVS.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received February 5, 2018.
- Revision received April 2, 2018.
- Accepted May 8, 2018.
- 2018 American College of Cardiology Foundation
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