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. 2015 Feb;31(1):64-5.
doi: 10.1016/j.joa.2014.06.004. Epub 2014 Aug 7.

Left atrial anomalous muscular band detected by computed tomography before catheter ablation in a patient with atrial fibrillation

Katsunori Okajima  1 , Kimitake Imamura  1 , Gaku Kanda  1 , Akira Shimane  1
Affiliations

Left atrial anomalous muscular band detected by computed tomography before catheter ablation in a patient with atrial fibrillation

Katsunori Okajima et al. J Arrhythm. 2015 Feb.

Abstract

A 65-year-old man was referred to our hospital with persistent atrial fibrillation (AF). Before the ablation procedure, 3-dimensional computed tomography revealed a left atrial anomalous muscular band connecting the posterior side of the left atrial roof and the right edge of the fossa ovalis. During the first ablation procedure, the band interfered with the manipulation of the catheter, resulting in only the left pulmonary vein (PV) being isolated. However, AF recurred. During the second procedure, careful catheter manipulation permitted complete right PV isolation, after which, the patient has not had AF recurrence for more than 3 years.

Keywords: Anomalous muscular band; Atrial fibrillation; Catheter ablation; Left atrium.

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Figures

Fig. 1
Fig. 1
Multi-detector computed tomography imaging of the anomalous muscular band using a left atrial endoscopic view (arrow). LSPV; left superior pulmonary vein (PV), LIPV; left inferior PV, RSPV; right superior PV, RIPV; right inferior PV, LAA; left atrial appendage, FO; foramen ovale.
Fig. 2
Fig. 2
Angiogram of the left atrium during the procedure. (A) Identification of the muscular band “translucent image” (red arrow). (B) Left pulmonary vein (PV) isolation using CARTO during the first procedure. (C) Left PV re-isolation and additional right PV isolation during the second procedure.
See this image and copyright information in PMC

References

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    1. Yamashita T., Imai T., Watanabe C. Prevalence and clinical significance of anomalous muscular band in the left atrium. Am J Cardiovasc Pathol. 1993;4:286–293. - PubMed

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