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Pulmonary Vein Stenosis After Second‐Generation Cryoballoon Ablation
Author(s) -
MATSUDA JUNJI,
MIYAZAKI SHINSUKE,
NAKAMURA HIROAKI,
TANIGUCHI HIROSHI,
KAJIYAMA TAKATSUGU,
HACHIYA HITOSHI,
TAKAGI TAKAMITSU,
IESAKA YOSHITO,
HIRAO KENZO,
ISOBE MITSUAKI
Publication year - 2017
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.13155
Subject(s) - medicine , cryoablation , balloon , pulmonary vein stenosis , stenosis , ablation , pulmonary vein , radiology , atrial fibrillation , cardiology
PV Stenosis After Cryoablation Background Pulmonary vein stenosis (PVST) can occur after first‐generation cryoballoon ablation. This study aimed to evaluate the incidence, severity, and characteristics of PVST after second‐generation cryoballoon ablation. Methods In total, 103 patients underwent PV isolation of paroxysmal atrial fibrillation using second‐generation cryoballoons with a single big‐balloon 3‐minute freeze technique. Cardiac enhanced multidetector computed tomography (MDCT) was performed both before and a median of 6.0 (4.0–8.0) months after the procedure in all. PVST was classified as follows: minimal (<25%), mild (25–50%), moderate (50–70%), or severe (>70%). Results In total, 406 PVs were analyzed. MDCT demonstrated PV stenosis in 10(2.5%) PVs among 8(7.8%) patients. In detail, minimal and mild PVSTs were observed in 6 and 4 PVs, respectively. PVST occurred in the left superior (LSPV), left inferior, and right superior PVs in 6, 1, and 3 PVs, respectively. No stenosis was observed in 15 PVs with active balloon deflations during freezing. All PVSTs had concentric patterns except for 2 PVs with minimal stenosis. Balloon deformities were observed during freezing of 2 PVs with mild stenosis. When the PVST was defined as a >25% decreased diameter, the incidence was 0.98% (4/406; including 3 LSPVs). PVST did not progress further during the follow‐up period. Conclusions Although the incidence of PVST was low, it could occur even if a single big‐balloon short freeze technique was applied. The risk of PV stenosis significantly differed among the 4 PVs, and reaching balloon temperatures of −60 °C and active balloon deflations during freezing were not associated with any PV stenosis.