Anatomical and Procedural Factors of Severe Pulmonary Vein Stenosis After Cryoballoon Pulmonary Vein Ablation
| Autor: | Kenichi Tokutake, Satoru Miyanaga, Teiichi Yamane, Kenichi Sugimoto, Eri Okajima, Hidenori Sato, Seigo Yamashita, Kenichi Yokoyama, Michihiro Yoshimura, Mika Kato, Hirotsuna Oseto, Michifumi Tokuda, Hirotsugu Ikewaki, Seiichiro Matsuo, Masaaki Yokoyama, Shin-ichi Tanigawa, Ryohsuke Narui, Ryota Isogai |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Operative Time 030204 cardiovascular system & hematology Balloon Cryosurgery Severity of Illness Index Pulmonary vein 03 medical and health sciences Postoperative Complications 0302 clinical medicine Internal medicine Atrial Fibrillation Occlusion Humans Medicine 030212 general & internal medicine Pulmonary vein stenosis Cryoballoon ablation Aged business.industry Atrial fibrillation Middle Aged medicine.disease Stenosis Stenosis Pulmonary Vein Pulmonary Veins Cardiology Female business Complication |
| Zdroj: | JACC: Clinical Electrophysiology. 5:1303-1315 |
| ISSN: | 2405-500X |
| Popis: | This study examined the anatomical or procedural factors associated with severe pulmonary vein (PV) stenosis after cryoballoon PV isolation.PV stenosis is a complication associated with cryoballoon ablation.The study included 170 consecutive patients with paroxysmal atrial fibrillation who underwent cryoballoon ablation. In addition to factors generally considered to be related to the occurrence of PV stenosis (PV size, cryoballoon application number and time, and minimum freezing temperature), we evaluated the following 4 factors: 1) depth of balloon position; 2) the PV angle (internal angle between each PV and horizontal line); 3) noncoaxial balloon placement (hemispherical occlusion); and 4) contact surface area between the cryoballoon and the PV wall (defined as the balloon contact ratio).Severe PV stenosis (≥75% area reduction) was observed in 9 (1.3%) PVs (6 left superior and 3 right superior PVs) in 9 patients. The PV size, cryoballoon application number and time, minimum freezing temperature, and the depth of cryoballoon position were not significantly associated with occurrence of severe PV stenosis, but the PV angle was significantly smaller in PVs with severe stenosis than it was in those without stenosis (25.6 ± 9.7° vs. 34.2 ± 6.4°; p 0.001). Hemispherical occlusion was more frequently observed and balloon contact ratio was larger in PVs with severe stenosis (55.6% vs. 14.8%; p = 0.049) than in those without stenosis (0.70 ± 0.06 vs. 0.54 ± 0.08; p 0.001).A horizontally connecting PV, noncoaxial placement of cryoballoon, and a larger contact surface area of the cryoballoon were predictors of the occurrence of severe PV stenosis after cryoballoon ablation. |
| Databáze: | OpenAIRE |
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