Stent implantation for severe pulmonary vein stenosis or occlusion secondary to atrial fibrillation ablation.

Stent implantation for severe pulmonary vein stenosis or occlusion secondary to atrial fibrillation ablation.:

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Stent implantation for severe pulmonary vein stenosis or occlusion secondary to atrial fibrillation ablation.

Int J Cardiol. 2019 Nov 28;:

Authors: Li YJ, Pan X, Wang C, He B

Abstract

BACKGROUND: Catheter interventional treatment of pulmonary vein stenosis or occlusion (PVS/O) following radiofrequency ablation (RFA) for atrial fibrillation (AF) remains a challenging field due to lacking randomized data and there are limited data about stenting.

METHODS: All patients at our center who underwent pulmonary vein stenosis (PVS) stenting for PVS/O induced by RFA were retrospectively assessed. Clinical presentation, anatomic site of stenosis and hemodynamic information, as well as follow-up data, were collected and analyzed.

RESULTS: From January 2010 to June 2018, 56 patients with PVS/O secondary to RFA were treated with 113 stents. Procedural success rate was 95.8%. Pressure gradients significantly reduced (p < 0.001) and vessel caliber markedly increased (p < 0.001) in all the stenotic sites, with immediate symptoms significantly improved. The overall in-stent restenosis (ISR) rate was 21.8% after a median follow-up period of 26 months (interquartile range: 16 to 35.5 months). The incidence of ISR was higher in patients treated with stent diameter ≤ 8 mm than those with stent diameter >8 mm (HR: 3.91; 95% CI 1.74-8.81; p = 0.001).

CONCLUSIONS: PVS stenting is a safe and effective procedure for PVS/O secondary to RFA. Long-term patency and good clinical outcomes are gained after bigger-diameter stent implantation.

PMID: 31813682 [PubMed - as supplied by publisher]