title: Prevalence, morphological and electrophysiological characteristics of confluent inferior pulmonary veins in patients with atrial fibrillation.
abstract: 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.
authors.affiliation: Department of Cardiology, Jikei University School of Medicine, Medical Center, Tokyo, Japan. yamanet1@aol.com
authors.forename: Teiichi
authors.initials: T
authors.lastname: Yamane
authors.forename: Taro
authors.initials: T
authors.lastname: Date
authors.forename: Michifumi
authors.initials: M
authors.lastname: Tokuda
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Aramaki
authors.forename: Keiichi
authors.initials: K
authors.lastname: Inada
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Matsuo
authors.forename: Kenri
authors.initials: K
authors.lastname: Shibayama
authors.forename: Satoru
authors.initials: S
authors.lastname: Miyanaga
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Miyazaki
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Tohru
authors.initials: T
authors.lastname: Sakuma
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Fukuda
authors.forename: Seibu
authors.initials: S
authors.lastname: Mochizuki
authors.forename: Michihiro
authors.initials: M
authors.lastname: Yoshimura
mesh_terms: 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