Severe Pulmonary Vein Stenosis Resulting From Ablation for Atrial Fibrillation: Presentation, Management, and Clinical Outcomes
An erratum to this article was published (Circulation, 2 May 2017 ↗)
Authors' conclusion
There is no difference in acute success by type of initial intervention; however, stenting significantly reduces the risk of subsequent pulmonary vein restenosis in comparison with BA.
Study context
- Population
- Patients with severe pulmonary vein stenosis (PVS) after ablation for AF, evaluated 2000–2014veins in 124 patients
- Participants
- 219 patients
- Exposure
- Balloon angioplasty with stenting vs balloon angioplasty alone
- Stentingn = 86reference
- Balloon angioplasty (BA)n = 92
- Not treatedn = 41
- Outcome
- Restenosis after intervention
- Follow-up
- 3 years
Main finding
As reported in the abstract
Restenosis
BA vs StentingHazard ratio (95% CI)P value
Unadjusted
2.77(1.72–4.45)
P < 0.001Adjusted for age, CHA2DS2-VASc, hypertension, study period
2.46(1.47–4.12)
P < 0.001- 3-year overall restenosis rate
- 37%
Observational data: associations, not effects.
Further findings
| Outcome | Stenting | BA | Not treated | |
|---|---|---|---|---|
| Restenosis, overall follow-up | 27% | 57% | Not reported in the abstract | Not treated: not reported in the abstract |
- Restenosis, overall follow-up — Overall restenosis (veins)
- 42%
Acute procedural success
- Acute procedural success, no difference by initial management
- 94%
Presentation at diagnosis
- Symptomatic at diagnosis
- 102 (82%)
- Dyspnea
- 67%
- Cough
- 45%
- Fatigue
- 45%
- Decreased exercise tolerance
- 45%
- Hemoptysis
- 27%
Safety
Procedural complications (113 patients with invasive assessment)
- Major complications
- 4 (3.5%)
- Minor complications
- 15 (13.3%)
Original publication
Severe Pulmonary Vein Stenosis Resulting From Ablation for Atrial Fibrillation: Presentation, Management, and Clinical Outcomes. Circulation. Published 28 October 2016. doi:10.
Summarised from the published abstract; every number is checked against it