on February 3, 2003
Published online before print February 3, 2003, doi: 10.1161/01.CIR.0000048146.81336.1D
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Submitted on August 6, 2002
From the Department of Cardiology (T.D., T.N., O.E., C.B., A.E., C.W.H., H.-F.P.), Kerckhoff Heart Center, Bad Nauheim, Germany; the Department of Radiology (G.B.), Kerckhoff Heart Center, Bad Nauheim, Germany; and the Department of Cardiac MRI (A.J.), Royal Brompton Hospital, London, UK. * To whom correspondence should be addressed. E-mail: thorsten.dill{at}kerckhoff.med.uni-giessen.de.
Background--Radiofrequency catheter ablation (RFCA) is a promising intervention to treat atrial fibrillation. However, pulmonary vein (PV) stenosis after RFCA has been reported. The aim of this study was to investigate the incidence and time course of pulmonary vein stenosis after RFCA within a period of 3 months. Contrast-enhanced magnetic resonance angiography (MRA) was used to visualize pulmonary veins and was compared with radiographic angiography. Methods and Results--Forty-six consecutive patients with symptomatic paroxysmal atrial fibrillation had RFCA in the orifice of 138 pulmonary veins. Comparison of diameters measured in 44 untreated vessels either by radiographic angiography or with MRA established the reliability of MRA (r=0.934). MRA measurements revealed an incidence of relevant diameter reductions of Conclusions--The occurrence and progression of PV stenosis is a potential significant complication of RFCA in the orifice of pulmonary veins. These findings may have an impact on the technical performance of this intervention. In addition, long-term studies will be necessary to evaluate lumen reduction over time. MRA is a noninvasive, reproducible imaging modality for this purpose.
Revised on October 29, 2002
Accepted on October 29, 2002
Pulmonary Vein Diameter Reduction After Radiofrequency Catheter Ablation for Paroxysmal Atrial Fibrillation Evaluated by Contrast-Enhanced Three-Dimensional Magnetic Resonance Imaging
Thorsten Dill MD*,
25% or stenosis of 50% after RFCA of 25 of 138 (18.1%) treated vessels 1 day and/or 3 months after ablation. A progression of diameter reduction after RFCA was observed in 8.3% (maximum 75%), whereas a regression was observed in 6.3% of treated PVs. Ablation at a radial angle of >180° of a pulmonary vein orifice increased the risk of diameter reduction significantly compared with ablation at a radial angle 
180° (P=0.002).
Key words: magnetic resonance imaging • catheter ablation • veins • fibrillation
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