0338: Computed tomography evaluation of the anatomical variation of the pulmonary veins in atrial fibrillation

Abstract

The electrophysiological and anatomical properties of the pulmonary veins (PVs) have been focused on since their crucial role in triggering or generating atrial fibrillation (AF) was first revealed. The presence of four distinct pulmonary veins (two left PVs and two right PVs) has been described as the normal variant. The purpose of our study was to describe the anatomy of the pulmonary veins in a cohort of patients of our country followed for AF. Our study is a prospective study which has included 38 patients followed for AF in the cardiology’s department of our Hospital. All patients underwent a CT scan of PVs in order to characterize their anatomy. PVs’ size was represented by the largest diameter. Our patients had a mean age of 50.5±13 years. The majority of our patients had paroxysmal AF (65.8%), 4 had persistent AF (10.5%), 9 had prolonged persistent AF (24%). AF occurred in 63.6% of cases in healthy heart and 36.4% in pathological heart, 13 patients had an anatomical variant which represent 34.2% of the population. We had 3.9 PVs in average with a minimum of 3 and a maximum of 5 PVs. The average diameter of different VP was 23.45±9.31mm for the left PVs and 19.75±7mm for the right PVs. 7 patients (18.4%) had anatomical variants interesting the left PVs with single ostium forming a core collector left in all cases. Concerning the right pulmonary veins, anatomical variations were found in 15.8% of cases, one patient (2.65%) had a single ostium forming a core right collector and 5 patients (13.15%) had 3 ostia (presence of 1 middle pulmonary veins on the right). Cardiac CT is a non invasive procedure which can provide a detailed evaluation of the anatomy of the pulmonary veins. The presence of anatomical variations is common in patients with AF. This assessment is recommended to ensure success of the ablation procedure.