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Antithrombotic therapy after angioplasty of pulmonary vein stenosis due to atrial fibrillation ablation: A two-center experience and review of the literature

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Antithrombotic therapy after angioplasty of pulmonary vein stenosis due to atrial fibrillation ablation: A two-center experience and review of the literature. / Fink, Thomas; Vogler, Julia; Proietti, Riccardo; Sciacca, Vanessa; Heeger, Christian-Hendrik; Rottner, Laura; Maurer, Tilman; Metzner, Andreas; Mathew, Shibu; Eitel, Charlotte; Eitel, Ingo; Sohns, Christian; Sano, Makoto; Reissmann, Bruno; Rillig, Andreas; Ouyang, Feifan; Kuck, Karl-Heinz; Tilz, Roland Richard.

In: J ARRYTHM, Vol. 38, No. 6, 12.2022, p. 1009-1016.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Fink, T, Vogler, J, Proietti, R, Sciacca, V, Heeger, C-H, Rottner, L, Maurer, T, Metzner, A, Mathew, S, Eitel, C, Eitel, I, Sohns, C, Sano, M, Reissmann, B, Rillig, A, Ouyang, F, Kuck, K-H & Tilz, RR 2022, 'Antithrombotic therapy after angioplasty of pulmonary vein stenosis due to atrial fibrillation ablation: A two-center experience and review of the literature', J ARRYTHM, vol. 38, no. 6, pp. 1009-1016. https://doi.org/10.1002/joa3.12777

APA

Fink, T., Vogler, J., Proietti, R., Sciacca, V., Heeger, C-H., Rottner, L., Maurer, T., Metzner, A., Mathew, S., Eitel, C., Eitel, I., Sohns, C., Sano, M., Reissmann, B., Rillig, A., Ouyang, F., Kuck, K-H., & Tilz, R. R. (2022). Antithrombotic therapy after angioplasty of pulmonary vein stenosis due to atrial fibrillation ablation: A two-center experience and review of the literature. J ARRYTHM, 38(6), 1009-1016. https://doi.org/10.1002/joa3.12777

Vancouver

Fink T, Vogler J, Proietti R, Sciacca V, Heeger C-H, Rottner L et al. Antithrombotic therapy after angioplasty of pulmonary vein stenosis due to atrial fibrillation ablation: A two-center experience and review of the literature. J ARRYTHM. 2022 Dec;38(6):1009-1016. https://doi.org/10.1002/joa3.12777

Bibtex

@article{756355e9def74088bafc775793cb340b,
title = "Antithrombotic therapy after angioplasty of pulmonary vein stenosis due to atrial fibrillation ablation: A two-center experience and review of the literature",
abstract = "BACKGROUND: Pulmonary vein stenosis (PVS) is a severe complication of atrial fibrillation (AF) ablation resulting in narrowing of affected pulmonary veins (PVs). Interventional treatment consists of angioplasty with or without PV stenting. The optimal postprocedural antithrombotic therapy is not known.STUDY AIMS: To investigate the impact of antithrombotic medical therapy on recurrence of PVS after PV angioplasty.METHODS: A retrospective study of patients undergoing PV angioplasty with or without stent implantation in two German centers was performed. Postinterventional antithrombotic therapy consisted of either dual antiplatelet therapy (DAPT) or a combination of oral anticoagulation with single or dual antiplatelet therapy for 3-12 months after intervention. Angiographic follow-up was recommended 3, 6, and 12 months after intervention and in case of symptom recurrence.RESULTS: Thirty patients underwent treatment of 42 PVS. After intervention, twenty-eight patients received triple therapy and 14 patients received dual therapy/DAPT; restenosis occurred in 5/22 (22.7%) patients with triple therapy and 8/14 (57.1%) patients with dual therapy/DAPT PV (p = .001). Estimated freedom from PV restenosis after 500 days was 18.8 ± 15.8% (dual therapy/DAPT) and 76.2 ± 10.5% (triple therapy) (p = .003). Univariate regression analysis revealed postprocedural medication as a significant risk factor for restenosis (p = .019). No bleeding events occurred regardless of applied antithrombotic therapy.CONCLUSION: Triple antithrombotic therapy after PV angioplasty is associated with less frequent restenosis as compared to dual antiplatelet therapy or a combination of anticoagulation and single antiplatelet therapy. No severe bleeding events occurred in patients on triple therapy. These findings need to be confirmed in larger patient cohorts.",
author = "Thomas Fink and Julia Vogler and Riccardo Proietti and Vanessa Sciacca and Christian-Hendrik Heeger and Laura Rottner and Tilman Maurer and Andreas Metzner and Shibu Mathew and Charlotte Eitel and Ingo Eitel and Christian Sohns and Makoto Sano and Bruno Reissmann and Andreas Rillig and Feifan Ouyang and Karl-Heinz Kuck and Tilz, {Roland Richard}",
note = "{\textcopyright} 2022 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society.",
year = "2022",
month = dec,
doi = "10.1002/joa3.12777",
language = "English",
volume = "38",
pages = "1009--1016",
journal = "J ARRYTHM",
issn = "1880-4276",
publisher = "John Wiley & Sons Inc.",
number = "6",

}

RIS

TY - JOUR

T1 - Antithrombotic therapy after angioplasty of pulmonary vein stenosis due to atrial fibrillation ablation: A two-center experience and review of the literature

AU - Fink, Thomas

AU - Vogler, Julia

AU - Proietti, Riccardo

AU - Sciacca, Vanessa

AU - Heeger, Christian-Hendrik

AU - Rottner, Laura

AU - Maurer, Tilman

AU - Metzner, Andreas

AU - Mathew, Shibu

AU - Eitel, Charlotte

AU - Eitel, Ingo

AU - Sohns, Christian

AU - Sano, Makoto

AU - Reissmann, Bruno

AU - Rillig, Andreas

AU - Ouyang, Feifan

AU - Kuck, Karl-Heinz

AU - Tilz, Roland Richard

N1 - © 2022 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society.

PY - 2022/12

Y1 - 2022/12

N2 - BACKGROUND: Pulmonary vein stenosis (PVS) is a severe complication of atrial fibrillation (AF) ablation resulting in narrowing of affected pulmonary veins (PVs). Interventional treatment consists of angioplasty with or without PV stenting. The optimal postprocedural antithrombotic therapy is not known.STUDY AIMS: To investigate the impact of antithrombotic medical therapy on recurrence of PVS after PV angioplasty.METHODS: A retrospective study of patients undergoing PV angioplasty with or without stent implantation in two German centers was performed. Postinterventional antithrombotic therapy consisted of either dual antiplatelet therapy (DAPT) or a combination of oral anticoagulation with single or dual antiplatelet therapy for 3-12 months after intervention. Angiographic follow-up was recommended 3, 6, and 12 months after intervention and in case of symptom recurrence.RESULTS: Thirty patients underwent treatment of 42 PVS. After intervention, twenty-eight patients received triple therapy and 14 patients received dual therapy/DAPT; restenosis occurred in 5/22 (22.7%) patients with triple therapy and 8/14 (57.1%) patients with dual therapy/DAPT PV (p = .001). Estimated freedom from PV restenosis after 500 days was 18.8 ± 15.8% (dual therapy/DAPT) and 76.2 ± 10.5% (triple therapy) (p = .003). Univariate regression analysis revealed postprocedural medication as a significant risk factor for restenosis (p = .019). No bleeding events occurred regardless of applied antithrombotic therapy.CONCLUSION: Triple antithrombotic therapy after PV angioplasty is associated with less frequent restenosis as compared to dual antiplatelet therapy or a combination of anticoagulation and single antiplatelet therapy. No severe bleeding events occurred in patients on triple therapy. These findings need to be confirmed in larger patient cohorts.

AB - BACKGROUND: Pulmonary vein stenosis (PVS) is a severe complication of atrial fibrillation (AF) ablation resulting in narrowing of affected pulmonary veins (PVs). Interventional treatment consists of angioplasty with or without PV stenting. The optimal postprocedural antithrombotic therapy is not known.STUDY AIMS: To investigate the impact of antithrombotic medical therapy on recurrence of PVS after PV angioplasty.METHODS: A retrospective study of patients undergoing PV angioplasty with or without stent implantation in two German centers was performed. Postinterventional antithrombotic therapy consisted of either dual antiplatelet therapy (DAPT) or a combination of oral anticoagulation with single or dual antiplatelet therapy for 3-12 months after intervention. Angiographic follow-up was recommended 3, 6, and 12 months after intervention and in case of symptom recurrence.RESULTS: Thirty patients underwent treatment of 42 PVS. After intervention, twenty-eight patients received triple therapy and 14 patients received dual therapy/DAPT; restenosis occurred in 5/22 (22.7%) patients with triple therapy and 8/14 (57.1%) patients with dual therapy/DAPT PV (p = .001). Estimated freedom from PV restenosis after 500 days was 18.8 ± 15.8% (dual therapy/DAPT) and 76.2 ± 10.5% (triple therapy) (p = .003). Univariate regression analysis revealed postprocedural medication as a significant risk factor for restenosis (p = .019). No bleeding events occurred regardless of applied antithrombotic therapy.CONCLUSION: Triple antithrombotic therapy after PV angioplasty is associated with less frequent restenosis as compared to dual antiplatelet therapy or a combination of anticoagulation and single antiplatelet therapy. No severe bleeding events occurred in patients on triple therapy. These findings need to be confirmed in larger patient cohorts.

U2 - 10.1002/joa3.12777

DO - 10.1002/joa3.12777

M3 - SCORING: Journal article

C2 - 36524033

VL - 38

SP - 1009

EP - 1016

JO - J ARRYTHM

JF - J ARRYTHM

SN - 1880-4276

IS - 6

ER -