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Observational Study
. 2024 Oct;15(5):616-622.
doi: 10.1007/s13239-024-00738-x. Epub 2024 Jun 18.

Pulmonary Vein Morphology in Patients Undergoing Catheter Ablation of Atrial Fibrillation

Farkasová Barbora  1   2 , Toman Ondřej  3   4 , Pospíšil David  1   2 , Míková Monika  1   2 , Hejtmánková Nela  1 , Zouharová Anna  5 , Křikavová Lucie  6 , Fiala Martin  2   7 , Sepši Milan  1   2 , Kala Petr  1   2 , Novotný Tomáš  1   2
Affiliations
Observational Study

Pulmonary Vein Morphology in Patients Undergoing Catheter Ablation of Atrial Fibrillation

Farkasová Barbora et al. Cardiovasc Eng Technol. 2024 Oct.

Abstract

Purpose: Variations in the anatomy of pulmonary veins can influence selection of approaches of atrial fibrillation catheter ablation. Therefore, preprocedural evaluation and knowledge of pulmonary veins anatomy is crucial for proper mapping and the successful ablation of atrial fibrillation. The aim of this observational study was to assess CT angiography scans and perform detailed analysis of pulmonary veins morphology in patients scheduled for catheter ablation of atrial fibrillation.

Methods: CT angiography was performed in 771 individuals (223 females, 548 males, mean age 58.4 ± 10.7 years). Pulmonary veins anatomy was evaluated using 3D models. The patterns used for evaluation included typical anatomy with four separate pulmonary veins, a common left ostium, and various types of accessory veins either alone or in combination with common left ostia.

Results: An anatomical variant with common left ostium was observed as the most prevalent anatomy (44%). The typical variant was observed in 34.8% of patients. Accessory pulmonary veins were observed predominantly on the right side. The prevalence of anatomical variants did not differ between sexes with the exception of the unclassifiable category U (4.4% vs. 9%, p < 0.05).

Conclusions: Our study shows that a considerable number of atypical anatomies is present in patients undergoing AF catheter ablation. This knowledge may influence the choice of instrumentation. The data could be possibly helpful also in development of new ablation techniques.

Keywords: Atrial fibrillation; CT angiography; Pulmonary veins anatomy; Pulmonary veins morphology.

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Conflict of interest statement

Declarations. Competing interests: The authors declare that there are no competing financial interests or personal relationships that may have directly or indirectly affected this manuscript. Ethics approval: The Ethics Board exempted the protocol of the survey from the standard approval process because all of the procedures are part of a standard clinical workout. Informed Consent: All patients consented separately to each individual investigation and gave written approval for scientific use of the obtained data.

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