Assessments of pulmonary vein and left atrial anatomical variants in atrial fibrillation patients for catheter ablation with cardiac CT

Chen, Jing; Yang, Zhi‐gang; Xu, Huayan; Shi, Ke; Long, Qihua; Guo, Yingkun

doi:10.1007/s00330-016-4411-6

Cited by 48 publications

(43 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Second, our study measured AP, SI diameter, area, and ostial index of PVs, leading to the following five points: ostial sizes of superior PVs are larger than those of inferior PVs; ostial sizes of right PVs are larger than those of left PVs; the ostial size of CLT is the largest; the ostial size of RMPV is the smallest; and superior PV, inferior PV, and RMPV ostia on the right tend to be more circular, whereas left common ostia tend to have a more oval shape. These five points are consistent with previous studies (8,11,16,20), but afford more information. PV ostial size facilitated the selection of the size of catheters and selection of appropriate energy to avoid stenosis.…”

Section: Discussionsupporting

confidence: 92%

“…Contradictory suggestions have been made about whether the prevalence of accessory PV is significantly different from common PV or not. Chen et al suggested that RMPV was the most common variant (20), and Kanaji et al found that the most common variant was a common PV (21). However, our study found that the prevalence of accessory PV is equal to common PV.…”

Section: Discussioncontrasting

confidence: 85%

“…The right side tends to be complex, often having one or more accessory veins, whereas the left side tends to be simplified, often having common veins, which rarely occur on the right. Some newly named PV variants were found in a consecutive large series of patients with AF or not (20). Contradictory suggestions have been made about whether the prevalence of accessory PV is significantly different from common PV or not.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of pulmonary vein anatomy using 256-slice computed tomography

Shi¹,

Mi²,

Shi³

et al. 2017

Turk J Med Sci

View full text Add to dashboard Cite

Background/aim: This study aimed to evaluate pulmonary vein (PV) anatomy using 256-slice computed tomography (CT), which may be necessary for electrophysiologists to know before radiofrequency catheter ablation (RFCA) therapy. Materials and methods:A total of 102 patients with paroxysmal and persistent atrial fibrillation underwent 256-slice cardiac CT angiography prior to catheter ablation. PV morphology, ostial diameter, ostial orientation, and distance from ostium to first bifurcation were evaluated using three-dimensional volume-rendering and multiplanar-reformatting technology. Results:We found that 72.5% of patients had four conventional PVs. On the right, 22.5% of patients had one accessory PV, 4.9% had 2 accessory PVs, 1% had one common PV, and 1% had one top vein. On the left, 27.5% of patients had one common PV. Additionally, 9.8% of patients had bilateral PV variation. Ostial size was larger for superior PVs than inferior PVs and larger for right PVs than left PVs. PV ostia on the right tended to be more circular. There was a rather wide variation of projective angle and distance from ostium to first bifurcation. Early branching occurred more often in the right inferior PV. Conclusion:256-Slice CT can depict PV anatomy and afford substantial data, which will help electrophysiologists conduct the RFCA procedure safely and efficiently.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussioncontrasting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of pulmonary vein anatomy using 256-slice computed tomography

Shi¹,

Mi²,

Shi³

et al. 2017

Turk J Med Sci

View full text Add to dashboard Cite

show abstract

“…Prior studies have investigated PV anatomy with focus on branching pattern, composition, size and ridges [15,16,27]. For comparison, McLellan, et al [16] describe in their study the dimensions of the PV ostia in a group of patients with AF with similar size distribution as in our study.…”

Section: Pulmonary Vein Cross-sectional Areamentioning

confidence: 60%

Left Atrial Wall Thickness and Pulmonary Vein Size are Increased in Patients with Atrial Fibrillation Compared to Healthy Controls - A Multidetector Computed Tomography Study

Thomsen¹

2017

Int J Clin Cardiol

View full text Add to dashboard Cite

“…Actually, PV variants are not rare mainly including common ostia and additional PVs. According to the available data, the left common pulmonary vein (LCPV) was found to be one of the most common variants with prevalence ranging from 7.5% to 43% among different studies . It has been reported that an LCPV was a consistent source of arrhythmogenic atrial ectopy which might predispose to AF .…”

Section: Introductionmentioning

confidence: 99%

A left common pulmonary vein: Anatomical variant predicting good outcomes of repeat catheter ablation for atrial fibrillation

Xing

et al. 2019

Cardiovasc electrophysiol

View full text Add to dashboard Cite

Introduction A left common pulmonary vein (LCPV) is a common anatomical variant in atrial fibrillation (AF) patients. Whether an LCPV influences outcomes of repeated radiofrequency catheter ablation (RFCA) for AF has not been elucidated. Methods From a prospectively collected database, we enrolled 154 patients who received repeated RFCA for recurrent AF after the initial RFCA (56 ± 9 years, 72% paroxysmal AF, 32 patients with an LCPV, and 122 patients with typical left‐sided pulmonary veins [PVs]). Median postprocedural follow‐up was 26 months. The primary outcome was an episode of AF, atrial tachyarrhythmia, or atrial flutter lasting for more than 30 seconds, after the 3 months blanking period following the repeated procedure. Results After the follow‐up period, 75 patients suffered recurrence after repeated ablation. In the Kaplan‐Meier analysis, an LCPV was significantly associated with less recurrence (hazard ratio [HR]: 0.39; 95% confidence interval [CI]: 0.28‐0.79; P = 0.005). In subgroup analysis, the significant association persisted in paroxysmal AF patients. Regarding persistent AF patients, an LCPV tended to be associated with less recurrence with no statistical significance (HR: 0.40; 95% CI: 0.20‐1.03; P = 0.067). In multivariate analyses, an LCPV still independently predicted freedom from recurrence (HR: 0.44; 95% CI: 0.22‐0.88; P = 0.02). Conclusion Compared with typical left‐sided PVs, an LCPV was independently associated with better outcomes after repeated RFCA of AF, particularly in patients with paroxysmal AF.

show abstract

Assessments of pulmonary vein and left atrial anatomical variants in atrial fibrillation patients for catheter ablation with cardiac CT

Abstract: • PVs variants are helpful for providing anatomical road map to ablation. • PV variants are common. • DSCT could recognize these anatomic features before ablation as a non-invasive imaging.

Cited by 48 publications

References 36 publications

Evaluation of pulmonary vein anatomy using 256-slice computed tomography

Evaluation of pulmonary vein anatomy using 256-slice computed tomography

Left Atrial Wall Thickness and Pulmonary Vein Size are Increased in Patients with Atrial Fibrillation Compared to Healthy Controls - A Multidetector Computed Tomography Study

A left common pulmonary vein: Anatomical variant predicting good outcomes of repeat catheter ablation for atrial fibrillation

Contact Info

Product

Resources

About