Interv Akut Kardiol. 2021;20(1):37-43 | DOI: 10.36290/kar.2021.002

Evaluation of pulmonary vein anatomical variants in patients with atrial fibrillation

Barbora Farkasová, David Pospíšil, Tomáš Novotný, Monika Míková, Ondřej Toman, Milan Sepši, Petr Kala
Interní kardiologická klinika, Fakultní nemocnice Brno
Interní kardiologická klinika, Lékařská fakulta, Masarykova univerzita, Brno

This review summarizes and compares the methods and results of available original papers on the evaluation of anatomical variants of pulmonary veins in patients with atrial fibrillation published in the last two decades. The studies included show that an understanding of anatomical variants of pulmonary veins is an important prerequisite for successful catheter ablation of atrial fibrillation. The present text deals with an analysis and mutual comparison of the methods and results used in various evaluations of the original authors.

Keywords: pulmonary veins, atrial fibrillation, anatomical variants.

Received: January 27, 2021; Revised: January 27, 2021; Accepted: January 28, 2021; Prepublished online: January 28, 2021; Published: April 29, 2021  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Farkasová B, Pospíšil D, Novotný T, Míková M, Toman O, Sepši M, Kala P. Evaluation of pulmonary vein anatomical variants in patients with atrial fibrillation. Interv Akut Kardiol. 2021;20(1):37-43. doi: 10.36290/kar.2021.002.
Download citation

References

  1. Chugh SS, Havmoeller R, Narayanan K, et al. Worldwide epidemiology of atrial fibrillation: A global burden of disease 2010 study. Circulation. 2014; 129(8): 837-847. doi: 10.1161/CIRCULATIONAHA.113.005119. Go to original source... Go to PubMed...
  2. Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016; 37(38): 2893-2962. doi: 10.1093/eurheartj/ehw210. Go to original source... Go to PubMed...
  3. Istratoaie S, Roșu R, Cismaru G, et al. The impact of pulmonary vein anatomy on the outcomes of catheter ablation for atrial fibrillation. Med. 2019; 55(11): 1-10. doi: 10.3390/medicina55110727. Go to original source... Go to PubMed...
  4. Saito T, Waki K, Becker AE. Left atrial myocardial extension onto pulmonary veins in humans: Anatomic observations relevant for atrial arrhythmias. J Cardiovasc Electrophysiol. 2000; 11(8): 888-894. doi: 10.1111/j.1540-8167.2000.tb00068.x. Go to original source... Go to PubMed...
  5. Cheruiyot I, Munguti J, Olabu B, Gichangi P. A meta-analysis of the relationship between anatomical variations of pulmonary veins and atrial fibrillation. Acta Cardiol. 2020; 75(1): 1-9. doi: 10.1080/00015385.2018.1544204. Go to original source... Go to PubMed...
  6. Altinkaynak D, Koktener A. Evaluation of pulmonary venous variations in a large cohort: Multidetector computed tomography study with new variations. Wien Klin Wochenschr. 2019; 131(19-20): 475-484. doi: 10.1007/s00508-019-1517-2. Go to original source... Go to PubMed...
  7. Calkins H, Hindricks G, Cappato R, et al. 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Hear Rhythm. 2017; 14(10): e275-e444. doi: 10.1016/j.hrthm.2017.05.012. Go to original source... Go to PubMed...
  8. Mansour M, Refaat M, HEIST EK, et al. Three-dimensional anatomy of the left atrium by magnetic resonance angiography: Implications for catheter ablation for atrial fibrillation. J Cardiovasc Electrophysiol. 2006; 17(7): 719-723. doi: 10.1111/j.1540-8167.2006.00491.x. Go to original source... Go to PubMed...
  9. Polaczek M, Szaro P, Baranska I, Burakowska B, Ciszek B. Morphology and morphometry of pulmonary veins and the left atrium in multi-slice computed tomography. Surg Radiol Anat. 2019; 41(7): 721-730. doi: 10.1007/s00276-019-02210-1. Go to original source... Go to PubMed...
  10. Mlčochová H, Tintěra J, Porod V, Peichl P, Čihák R, Kautzner J. Magnetic resonance angiography of pulmonary veins: Implications for catheter ablation of atrial fibrillation. PACE - Pacing Clin Electrophysiol. 2005; 28(10): 1073-1080. doi: 10.1111/j.1540-8159.2005.00228.x Go to original source... Go to PubMed...
  11. Chen J, Yang ZG, Xu HY, Shi K, Long QH, Guo YK. Assessments of pulmonary vein and left atrial anatomical variants in atrial fibrillation patients for catheter ablation with cardiac CT. Eur Radiol. 2017; 27(2): 660-670. doi: 10.1007/s00330-016-4411-6. Go to original source... Go to PubMed...
  12. Ahmed J, Sohal S, Malchano ZJ, Holmvang G, Ruskin JN, Reddy VY. Three-dimensional analysis of pulmonary venous ostial and antral anatomy: Implications for balloon catheter-based pulmonary vein isolation. J Cardiovasc Electrophysiol. 2006; 17(3): 251-255. doi: 10.1111/j.1540-8167.2005.00339.x. Go to original source... Go to PubMed...
  13. Tsao HM, Yu WC, Cheng H, et al. Pulmonary vein dilation in patients with atrial fibrillation: Detection by magnetic resonance imaging. J Cardiovasc Electrophysiol. 2001; 12(7): 809-813. doi: 10.1046/j.1540-8167.2001.00809.x. Go to original source... Go to PubMed...
  14. Schwartzman D, Bazaz R, Nosbisch J. Common left pulmonary vein: A consistent source of arrhythmogenic atrial ectopy. J Cardiovasc Electrophysiol. 2004; 15(5): 560-566. doi: 10.1046/j.1540-8167.2004.03351.x. Go to original source... Go to PubMed...
  15. Takase B, Nagata M, Matsui T, et al. Pulmonary Vein Dimensions and Variation of Branching Pattern in Patients With Paroxysmal Atrial Fibrillation Using Magnetic Resonance Angiography. Jpn Heart J. 2004; 45(1): 81-92. doi: 10.1536/jhj.45.81. Go to original source... Go to PubMed...
  16. Perez-Lugones A, Schvartzman PR, Schweikert R, et al. Three-dimensional reconstruction of pulmonary veins in patients with atrial fibrillation and controls: Morphological characteristics of different veins. PACE - Pacing Clin Electrophysiol. 2003; 26(1 I): 8-15. doi: 10.1046/j.1460-9592.2003.00144.x. Go to original source... Go to PubMed...
  17. Kato R, Lickfett L, Meininger G, et al. Pulmonary vein anatomy in patients undergoing catheter ablation of atrial fibrillation: Lessons learned by use of magnetic resonance imaging. Circulation. 2003; 107(15): 2004-2010. doi: 10.1161/01.CIR.0000061951.81767.4E. Go to original source... Go to PubMed...
  18. Jongbloed MRM, Dirksen MS, Bax JJ, et al. Atrial fibrillation: Multi-detector row CT of pulmonary vein anatomy prior to radio-frequency catheter ablation - Initial experience. Radiology. 2005; 234(3): 702-709. doi: 10.1148/radiol.2343031047. Go to original source... Go to PubMed...
  19. Gebhard C, Krasniqi N, Stähli BE, et al. Characterization of pulmonary vein dimensions using high-definition 64-slice computed tomography prior to radiofrequency catheter ablation for atrial fibrillation. Cardiol Res Pract. 2014; 2014: 1-8. doi:10.1155/2014/179632. Go to original source... Go to PubMed...
  20. Skowerski M, Wozniak-Skowerska I, Hoffmann A, et al. Pulmonary vein anatomy variants as a biomarker of atrial fibrillation - CT angiography evaluation. BMC Cardiovasc Disord. 2018; 18(1): 1-7. doi: 10.1186/s12872-018-0884-3. Go to original source... Go to PubMed...
  21. Woźniak-Skowerska I, Skowerski M, Wnuk-Wojnar A, et al. Comparison of pulmonary veins anatomy in patients with and without atrial fibrillation: Analysis by multislice tomography. Int J Cardiol. 2011; 146(2): 181-185. doi: 10.1016/j.ijcard.2009.06.047. Go to original source... Go to PubMed...
  22. Lin WS, Prakash VS, Tai CT, et al. Pulmonary vein morphology in patients with paroxysmal atrial fibrillation initiated by ectopic beats originating from the pulmonary veins: Implications for catheter ablation. Circulation. 2000; 101(11): 1274-1281. doi: 10.1161/01.CIR.101.11.1274. Go to original source... Go to PubMed...
  23. Bittner A, Mnnig G, Vagt AJ, et al. Pulmonary vein variants predispose to atrial fibrillation: A case-control study using multislice contrast-enhanced computed tomography. Europace. 2011; 13(10): 1394-1400. doi: 10.1093/europace/eur145. Go to original source... Go to PubMed...
  24. Anselmino M, Blandino A, Beninati S, et al. Morphologic analysis of left atrial anatomy by magnetic resonance angiography in patients with atrial fibrillation: A large single center experience. J Cardiovasc Electrophysiol. 2011; 22(1): 1-7. doi: 10.1111/j.1540-8167.2010.01853.x. Go to original source... Go to PubMed...
  25. Tsao HM, Wu MH, Yu WC, et al. Role of right middle pulmonary vein in patients with paroxysmal atrial fibrillation. J Cardiovasc Electrophysiol. 2001; 12(12): 1353-1357. doi: 10.1046/j.1540-8167.2001.01353.x. Go to original source... Go to PubMed...
  26. Mansour M, Holmvang G, Sosnovik D, et al. Assessment of pulmonary vein anatomic variability by magnetic resonance imaging: Implications for catheter ablation techniques for atrial fibrillation. J Cardiovasc Electrophysiol. 2004; 15(4): 387-393. doi: 10.1046/j.1540-8167.2004.03515.x. Go to original source... Go to PubMed...
  27. Chu ZG, Gao HL, Yang ZG, et al. Pulmonary veins of the patients with atrial fibrillation: Dual-source computed tomography evaluation prior to radiofrequency catheter ablation. Int J Cardiol. 2011; 148(2): 245-248. doi: 10.1016/j.ijcard.2010.02.076. Go to original source... Go to PubMed...
  28. Angulo Hervias E, Guillén Subirán ME, Yagüe Romeo D, Castán Senar A, Seral Moral P, Núñez Motilva ME. Multidetector computed tomography in planning the treatment of atrial fibrillation. Radiol (English Ed. 2020; 62(2): 148-159. doi: 10.1016/j.rxeng.2019.11.002. Go to original source...
  29. Marom EM, Herndon JE, Kim YH, McAdams HP. Variations in Pulmonary Venous Drainage to the Left Atrium: Implications for Radiofrequency Ablation. Radiology. 2004; 230(3): 824-829. doi: 10.1148/radiol.2303030315. Go to original source... Go to PubMed...
  30. Polaczek M, Szaro P, Jakubowska L, Zych J, Religioni J, Orlowski TM. Pulmonary veins variations with potential impact in thoracic surgery: a computed-tomography-based atlas. J Thorac Dis. 2020; 12(3): 383-393. doi: 10.21037/jtd.2020.01.34. Go to original source... Go to PubMed...
  31. Tekbas G, Gumus H, Onder H, et al. Evaluation of pulmonary vein variations and anomalies with 64 slice multi detector computed tomography. Wien Klin Wochenschr. 2012; 124(1-2): 3-10. doi: 10.1007/s00508-011-0086-9. Go to original source... Go to PubMed...




Interventional Cardiology

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.