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Characteristics in Image Integration System Guiding Catheter Ablation of Atrial Fibrillation with a Common Ostium of Inferior Pulmonary Veins
Author(s) -
YU RONGHUI,
DONG JIANZENG,
ZHANG ZHAOQI,
LIU XINGPENG,
KANG JUNPING,
LONG DEYONG,
FANG DONGPING,
TANG RIBO,
GUO XI,
HU FULI,
MA CHANGSHENG
Publication year - 2008
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2007.00931.x
Subject(s) - medicine , ostium , catheter ablation , atrial fibrillation , ablation , pulmonary vein , catheter , left pulmonary vein , radiology , trunk , cardiology , ecology , biology
Background: 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.Methods: 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.Results: 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 strategy was 90%.Conclusion: Common ostium of inferior PVs could be classified into two types according to the presence of a short common trunk or not. The common ostium was usually an important triggering focus in paroxysmal AF. Catheter ablation strategy of circumferential PV isolation with “tricircle” under the guidance of image integration system would be a good choice.