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Background  Left atrial ( LA ) dilation is associated with morbidity of atrial fibrillation ( AF ). However, little is known about pulmonary vein ( PV ) dilation.    Purpose  We investigated the  PV  volume in the patients with  AF .    Methods and results  We performed 3dimensional computed tomography (3D CT ) in 155 patients and divided them into three groups: 19 patients without  AF  (non‐ AF  group, mean age 66 ± 12 years), 50 with paroxysmal  AF  ( PAF  group, mean age 67 ± 8 years) and 24 with persistent  AF  (Pe AF  group, mean age 64 ± 10 years). The absence of  AF  was diagnosed in patients with a cardiac implantable electronic device for at least 1 year (mean: 59 ± 37 months). We determined the  PV  volume as the total volume from the orifice to the first branch of each  PV . According to the echocardiographic data, the  LA  dimension ( LAD ) and  LA  volume index ( LAVI ) were largest in the Pe AF  group followed by the  PAF  and non‐ AF  group. According to the morphometric data obtained on 3D‐ CT , the  PV  volume was similar in Pe AF  and  PAF  groups but significantly smaller in the non‐ AF  group (median value: 24 vs 21 vs 14 mL, respectively). According to the receiver operating characteristic curve analysis, the area under the curve for the  PV  volume in the presence of  AF  was 0.80, and the optimum cut‐off value was 17 mL (sensitivity 74%, specificity 80%).    Conclusion  The  PV  volume might be useful for predicting the presence of  AF  before increases in the  LAD  and  LAVI  on echocardiography.

Can an increase in the pulmonary vein volume measured by three dimensional computed tomography predict the presence of atrial fibrillation?