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Pulmonary Vein Morphology in Patients Undergoing Catheter Ablation of Atrial Fibrillation

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FARKASOVÁ Barbora TOMAN Ondřej POSPÍŠIL David MÍKOVÁ Monika HEJTMANKOVA Nela ZOUHAROVA Anna KRIKAVOVA Lucie FIALA Martin SEPŠI Milan KALA Petr NOVOTNÝ Tomáš

Rok publikování 2024
Druh Článek v odborném periodiku
Časopis / Zdroj Cardiovascular Engineering and Technology
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
www https://link.springer.com/article/10.1007/s13239-024-00738-x
Doi http://dx.doi.org/10.1007/s13239-024-00738-x
Klíčová slova Atrial fibrillation; Pulmonary veins morphology; Pulmonary veins anatomy; CT angiography
Popis 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.
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