Pulmonary Vein Intervention for Severe Pulmonary Vein Stenosis After Atrial Fibrillation Ablation　― A Retrospective Cohort Study ―

Abstract

outcomes, to help establish optimal diagnostic and treatment procedures for this iatrogenic complication. Methods Study PatientsThis multicenter retrospective observational study was conducted at 3 cardiovascular centers in Japan (Saga University Hospital, Kokura Memorial Hospital, and Sagaken Medical Centre Koseikan). Thirty patients who were clinically indicated to undergo PV intervention for PVS or PV occlusion after AF ablation between 2010 and 2023 were enrolled in the study. Thirty paients with 56 lesions in 43 PV interventional procedures were analyzed retrospectively. PVS was defined as >75% stenosis or total occlusion evaluated by contrast-enhanced computed tomography (CT). The clinical indications for PV intervention were D ue to the aging population in Japan, the number of patients with atrial fibrillation (AF) is increasing rapidly. 1,2 Catheter ablation, mainly pulmonary vein (PV) isolation, is actively performed to maintain sinus rhythm. 3,4 However, severe PV stenosis has been reported (frequency 0.5-4.0%) as a serious complication of catheter ablation in the chronic phase, and can be fatal if not treated appropriately. 5-8 Percutaneous PV intervention is a treatment option for PV stenosis (PVS), but the diagnostic and treatment procedures have not yet been established due to the limited number of reported cases in Japan. 9 The number of catheter ablation cases in Japan is increasing every year, 2 and PV intervention for PVS is predicted to increase in the future. The aim of the present study was to investigate and describe data on PV intervention for PVS from a multicenter registry, including patient background, interventional procedures, and long-term