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

Abstract Background A displaced left B1 + 2 accompanied by an anomalous pulmonary vein is a rare condition involving complex structures. There is a risk of unexpected injuries to bronchi and blood vessels when patients with such anomalies undergo surgery for lung cancer. Case presentation A 59-year-old male with suspected lung cancer in the left lower lobe was scheduled to undergo surgery. Chest computed tomography revealed a displaced B1 + 2 and hyperlobulation between S1 + 2 and S3, while the interlobar fissure between S1 + 2 and S6 was completely fused. Three-dimensional computed tomography (3D-CT) revealed an anomalous V1 + 2 joining the left inferior pulmonary vein and a branch of the V1 + 2 running between S1 + 2 and S6. We performed left lower lobectomy via video-assisted thoracic surgery, while taking care with the abovementioned anatomical structures. The strategy employed in this operation was to preserve V1 + 2 and confirm the locations of B1 + 2 and B6 when dividing the fissure. Conclusion The aim of the surgical procedure performed in this case was to divide the fissure between S1 + 2 and the inferior lobe to reduce the risk of an unexpected bronchial injury. 3D-CT helps surgeons to understand the stereoscopic positional relationships among anatomical structures.

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Three-Dimensional Impedance Mapping as an Aid to Circumferential Pulmonary Vein Isolation in Paroxysmal Atrial Fibrillation

Revista Española de Cardiología (English Edition) ◽

10.1016/s1885-5857(09)71563-4 ◽

2009 ◽

Vol 62 (3) ◽

pp. 315-319

Author(s):

Alonso Pedrote ◽

Eduardo Arana-Rueda ◽

Lorena García-Riesco ◽

Adriano Jiménez-Velasco ◽

Juan Sánchez-Brotons ◽

...

Keyword(s):

Atrial Fibrillation ◽

Pulmonary Vein ◽

Pulmonary Vein Isolation ◽

Paroxysmal Atrial Fibrillation ◽

Three Dimensional ◽

Circumferential Pulmonary Vein Isolation

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Mechanism of improvement in atrial functional mitral regurgitation after catheter ablation for atrial fibrillation: Three‐dimensional analysis using multislice computed tomography

Journal of Cardiac Surgery ◽

10.1111/jocs.16120 ◽

2021 ◽

Author(s):

Yuta Tsujisaka ◽

Shuichiro Kaji ◽

Kitae Kim ◽

Misun Pak ◽

Yasuhiro Sasaki ◽

...

Keyword(s):

Computed Tomography ◽

Atrial Fibrillation ◽

Catheter Ablation ◽

Mitral Regurgitation ◽

Dimensional Analysis ◽

Multislice Computed Tomography ◽

Three Dimensional ◽

Functional Mitral Regurgitation

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Abstract 16807: Role of Rotor Activation Within the Pulmonary Vein as the Driving Sources for Atrial Fibrillation: Three-dimensional Analysis using a Non-contact Mapping System

Circulation ◽

10.1161/circ.132.suppl_3.16807 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Hiroshige Yamabe ◽

Hisanori Kanazawa ◽

Tadashi Hoshiyama ◽

Miwa Ito ◽

Shozo Kaneko ◽

...

Keyword(s):

Atrial Fibrillation ◽

Pulmonary Vein ◽

Three Dimensional ◽

Recording Site ◽

Contact Mapping ◽

Proximal Half ◽

Mapping System ◽

Endocardial Mapping ◽

Activation Sequence

Background: It has been suggested rotor which is located within the pulmonary vein (PV) acted as the driving sources of atrial fibrillation (AF). However, it has never been confirmed whether or not the rotor exists within PV in human. Objectives: We analyzed the activation sequence within the PV during AF and examined how the PV acted as the driving sources of AF. Methods: Selective endocardial mapping of left superior PV (LSPV) was performed during AF in 11 paroxysmal AF patients using a non-contact mapping system (EnSite 3000). Presence of rotor activation was defined when the circular activation around the functional block line once completed its whole reentrant activation. We analyzed the relation between the pivoting activation and the rotor activation. To define the preferable site of rotor and pivoting activation, we also analyzed the relation between the location of rotor and pivoting activation and region of the complex fractionated electrogram (CFE) recording site. Results: Rotor activation was observed with a mean number of 4.6±3.6 times/sec. CFE was observed at the roof (n=5), ridge (n=11) and carina (n=7) of the proximal half of LSPV with a mean area of 9.1±3.4 cm2. The number of rotor activation observed at the CFE area was significantly higher than that at the non-CFE area (4.1±3.9 vs. 0.7±1.2 times/sec, p=0.025). Total frequency of pivoting activation was 37.0±14.7 times/sec. Pivoting activation involved in the rotor activation was significantly lower than that not involved in the rotor activation (8.8±8.1 vs. 27.7±15.8 times/sec, p=0.0116). Regarding the CFE area, pivoting activation involved in the rotor activation was also significantly lower than that not involved in the rotor activation (8.4±8.2 vs. 24.1±12.0 times/sec, p=0.0105). However, there was no difference between the frequencies of pivoting activation with and without rotor activation in the non-CFE area (1.0±2.0 vs. 3.6±6.1 times/sec, p=NS). Conclusions: Rotor activation was observed at the proximal portion of the LSPV coincided with the location of CFE area. However, most of pivoting activation was not involved in the rotor activation. These suggest that AF was driven by the other meandering propagation associated with frequent non-stable pivoting activation over the CFE area.

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