PULMONARY VEIN MORPHOLOGY IN PATIENTS UNDERGOING CATHETER ABLATION OF ATRIAL FIBRILLATION

Variations in the anatomy of pulmonary veins (PVs) can influence selection of approaches of atrial fibrillation (AF) catheter ablation. Therefore, preprocedural evaluation and knowledge of PV anatomy is crucial for proper mapping and the successful ablation of AF. The aim of this observational study was to assess CT angiography scans and perform detailed analysis of PV morphology in patients scheduled for catheter ablation of AF. CT angiography was performed in 771 inividuals (223 females, 548 males, mean age 58.4 ± 10.7 years). PV anatomy was evaluated using 3D models. The patterns used for evaluation included typical anatomy with four separate PVs, a common left ostium, and various types of accessory veins either alone or in combination with common left ostia. 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 PVs 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). Information about a considerable number of atypical anatomies is as important as knowledge and understanding of the anatomical variations of PVs. This may influence the choice of instrumentation.