Prevalence, morphological and electrophysiological characteristics of confluent inferior pulmonary veins in patients with atrial fibrillation.
BACKGROUND
Although the common trunk of left pulmonary veins (PVs) has been reported as a relatively popular anatomical variation of PVs, little is known about the coalescence of contralateral PVs. The present study was conducted to reveal the prevalence and electrophysiologic characteristics of the confluent inferior common PVs.


RESULTS
Anatomical variation in the PV drainage to the left atrium (LA) was assessed using the multidetector computed tomography scan in 326 patients with atrial fibrillation (AF) who underwent the PV isolation procedure. Coalescence of inferior PVs was observed in 5 cases (1.5%). Both inferior PVs conjoined prior to the junction with the LA in 3 cases, while they coalesced at the LA junction in the other 2 cases. The arrhythmogenic activities of the confluent inferior PVs were generally low in all cases without any ectopic firings triggering the observed AF. All inferior PVs, as well as the superior PVs, were successfully isolated either en bloc at the common trunk or individually at the orifice of each PV.


CONCLUSIONS
Confluent inferior PVs were present in 1.5% of cases in patients with AF who underwent the PV isolation procedure. Preoperative recognition of this venous anomaly by 3-dimensional imaging is important for smooth and safe ablation.
Yamane
Teiichi
T
Department of Cardiology, Jikei University School of Medicine, Medical Center, Tokyo, Japan. yamanet1@aol.com
Date
Taro
T
Tokuda
Michifumi
M
Aramaki
Yasuko
Y
Inada
Keiichi
K
Matsuo
Seiichiro
S
Shibayama
Kenri
K
Miyanaga
Satoru
S
Miyazaki
Hidekazu
H
Sugimoto
Ken-ichi
K
Sakuma
Tohru
T
Fukuda
Kunihiko
K
Mochizuki
Seibu
S
Yoshimura
Michihiro
M
D000200:Action Potentials; D001281:Atrial Fibrillation / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011667:Pulmonary Veins / Q000002:abnormalities* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D011857:Radiographic Image Interpretation, Computer-Assisted; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D054079:Vascular Malformations / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D014656:Vascular Surgical Procedures