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Long-term follow-up in patients treated by stent implantation for post-ablation pulmonary vein stenosis

Authors
  • Iversen, Elisabeth1
  • Packer, Erik J. S.1
  • Sandberg, Synne M.1
  • Bleie, Øyvind1
  • Hoff, Per Ivar1
  • Schuster, Peter1, 2
  • 1 Haukeland University Hospital, Department of Heart Disease, Bergen, N-5021, Norway , Bergen (Norway)
  • 2 University of Bergen, Department of Clinical Science, Bergen, Norway , Bergen (Norway)
Type
Published Article
Journal
Journal of Interventional Cardiac Electrophysiology
Publisher
Springer-Verlag
Publication Date
Apr 18, 2018
Volume
53
Issue
3
Pages
309–315
Identifiers
DOI: 10.1007/s10840-018-0370-y
Source
Springer Nature
Keywords
License
Yellow

Abstract

PurposeSymptomatic severe pulmonary vein stenosis (PVS) after catheter ablation of atrial fibrillation (AF) is a rare but well-recognized complication. Treatment options include pulmonary vein angioplasty with or without drug eluting balloons or angioplasty with stent implantation. The treatment of choice is unclear. In our center, pulmonary vein stenting is the treatment of choice for significantly stenotic veins. We present the long-term clinical outcome of 9 patients treated with stent implantation.MethodsBetween 2001 and 2015, 3048 patients with AF were treated with catheter ablation at our institution, of which 9 developed symptomatic PVS. A total of 11 PVS were treated. Pre-procedural imaging (CT, MR, transesophageal echocardiography, angiography) was performed in all patients.ResultsMean time from ablation to stenting was 18 months. Three patients had recurrent pneumonia and the remaining reduced functional capacity (NYHA 2). All patients were in functional capacity NYHA 1 (p < 0.05) after a mean follow-up of 64 (18–132) months. Three patients still had paroxysmal AF, of which two have undergone repeated ablation.ConclusionsSymptomatic PVS after AF ablation can be successfully treated by stent implantation with durable results and good clinical outcome. AF ablation is still a feasible option after stent deployment.

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