Abstract
Common ostium of the inferior pulmonary veins (PVs) is a kind of unusual variation in pulmonary venous drainage to the left atrium (LA), whose feature of anatomy, electrophysiology, and catheter ablation is rarely demonstrated, and the consecutive series of research for catheter ablation of atrial fibrillation (AF) in patients with that anomaly have not been reported. A total of 1,226 patients with drug-refractory AF received magnetic resonance angiography (MRA) or multidetector computed tomography (MDCT) scan before ablation. Electrophysiological mapping was used to detect the focal triggers in paroxysmal AF. Basic catheter ablation strategy was circumferential PV isolation with "tricircle" under the guidance of image integration system: two circles surround two superior PVs, and the other surround the common trunk. LA and PVs reconstruction by image integration system showed a common pulmonary venous ostium of the right and left inferior PVs before ablation in 11 patients (0.9%). This anomaly could be classified into two types: type A without a short common trunk of inferior PVs and type B with a short common trunk. Fifty-seven percent paroxysmal AF was revealed focal triggers in the common ostium. The success rate of that st...Continue Reading
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Sep 29, 2011·Circulation. Arrhythmia and Electrophysiology·Seung-Young RohYoung-Hoon Kim
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