Effect of left superior pulmonary vein fat pad on atrial fibrillation in dogs

2011 ◽  
Vol 31 (9) ◽  
pp. 969-973
Author(s):  
Zhi-jian YANG ◽  
Yang XIA ◽  
Liang ZHAO ◽  
Jia-you ZHANG ◽  
Shu-jun JIANG ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Fat Pad ◽  
Superior Pulmonary Vein

scholarly journals Variations in Draining Patterns of Right Pulmonary Veins at the Hilum and an Anatomical Classification

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
M. S. Rajeshwari ◽  
Priya Ranganath
Keyword(s):  
Atrial Fibrillation ◽  
Mr Imaging ◽  
Left Atrium ◽  
Pulmonary Vein ◽  
Ct Angiography ◽  
Pulmonary Veins ◽  
Inferior Pulmonary Vein ◽  
Superior Pulmonary Vein ◽  
Anatomical Classification ◽  
The Right

Pulmonary veins carry oxygenated blood from the lungs to the left atrium. Variations are quite common in the pattern of drainage. The present study was undertaken to evaluate the incidence of different draining patterns of the right pulmonary veins at the hilum by dissecting the human fixed cadaveric lungs. Clinically, pulmonary veins have been demonstrated to often play an important role in generating atrial fibrillation. Hence, it is important to look into the anatomy of the veins during MR imaging and CT angiography. In 53.8% of cases, the right superior lobar vein and right middle lobar vein were found to be united together to form the right superior pulmonary vein. In contrast to this, in 11.53% of cases, right middle lobar vein united with the right inferior lobar vein to form the right inferior pulmonary vein, while in 26.9% of cases, the right superior lobar vein, right middle lobar vein, and right inferior lobar vein drained separately.

scholarly journals Novel Clue to Locate Conduction Gaps in the Pulmonary Vein Isolation Ablation Line

2021 ◽  
Vol 8 ◽  
Author(s):  
Hai-yang Xie ◽  
Xiao-gang Guo ◽  
Jian-du Yang ◽  
Yan-qiao Chen ◽  
Zhong-jing Cao ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Validation Cohort ◽  
Far Field ◽  
Prospective Evaluation ◽  
Superior Pulmonary Vein ◽  
Interval Value ◽  
Ablation Line ◽  
Novel Algorithm

Background: Several methods have been reported for locating the conduction gap (CG) in the pulmonary vein isolation (PVI) ablation line. However, the value of the interval between far-field atrial potential (FFP) and pulmonary vein potential (PVP) remains unknown.Methods: Consecutive patients with a CG during observation on the table after PVI were included. The PVP, FFP, and the CG location were evaluated to develop a novel algorithm to identify the CG location in the left superior pulmonary vein. The performance of this novel algorithm was prospectively tested in a validation cohort of consecutive patients undergoing repeat PVI ablation.Results: A total of 116 patients with atrial fibrillation (AF) were recruited, 56 of whom formed the validation cohort. The interval between FFP and PVP of the left superior pulmonary vein was associated with the CG location, and an interval <5 ms predicted the presence of CG in the upper portion of the ostium with a sensitivity of 92.9% and a specificity of 96.9%. In the prospective evaluation, the interval was able to correctly predict the site of CG in 89.6% of cases.Conclusions: The interval between FFP and PVP is a novel and accurate index that can be used to predict the CG location in the left superior pulmonary vein. An far-field atrial potential and pulmonary vein potential (FFP–PVP) interval value of ≥5 ms could be used to exclude a CG in the upper portion of the ostium in the majority of patients undergoing AF ablation.

Electrical connections between left superior pulmonary vein, left atrium, and ligament of Marshall: implications for mechanisms of atrial fibrillation

2006 ◽  
Vol 290 (1) ◽  
pp. H312-H322 ◽  
Author(s):  
Alex Y. Tan ◽  
Chung-Chuan Chou ◽  
Shengmei Zhou ◽  
Motoki Nihei ◽  
Chun Hwang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrium ◽  
Pulmonary Vein ◽  
Accessory Pathway ◽  
Electrical Coupling ◽  
Anterior Wall ◽  
Density Mapping ◽  
Superior Pulmonary Vein ◽  
Before And After ◽  
Electrical Connections

The importance of the ligament of Marshall (LOM) to rapid activations within the left superior pulmonary vein (LSPV) during atrial fibrillation (AF) remains poorly understood. We aimed to characterize the importance of electrical coupling between the LSPV with the left atrium (LA) and the LOM in the generation of high-frequency activations within this PV. We performed high-density mapping of the LSPV-LA-LOM junction in eight dogs, using 1,344 electrodes with a 1-mm resolution before and after posterior ostial ablation to diminish PV-LA electrical connections. A LOM potential was recordable up to 6.5 mm (SD 2.2) into the LSPV in all dogs during sinus rhythm (SR) and LA pacing. Functional LOM-LSPV electrical connections bypassing the PV-LA junction were present in five of eight dogs. Direct LOM-LSPV connections contributed to 46.5% (SD 16.0) of LSPV activations during AF, resulting in a greater propensity to develop focal activations ( P < 0.05) and a higher activation rate during AF of LSPVs with direct LOM connections compared with those without ( P < 0.03). Posterior LSPV ostial ablation without damaging the anterior wall or LOM slowed residual LA-PV conduction ( P < 0.001). This diminished PV-LA coupling prevented the reinduction of LSPV focal activations in all dogs. However, persistent LOM focal activations in two dogs continued to activate the LSPV rapidly [cycle length 151.8 ms (SD 4.8)] via direct LOM-LSPV connections. LOM-LSPV connection forms an accessory pathway that contributes to the electrical coupling between LSPV and LA during SR and AF. This pathway may contribute to rapid activations within the LSPV during AF.

scholarly journals Abutting left atrial appendage and left superior pulmonary vein predicts recurrence of atrial fibrillation after point-by-point pulmonary vein isolation

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
N Szegedi ◽  
J Simon ◽  
B Szilveszter ◽  
Z Sallo ◽  
S Herczeg ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Pulmonary Vein ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Female Gender ◽  
Atrial Appendage ◽  
Female Sex ◽  
Superior Pulmonary Vein ◽  
Af Recurrence

Abstract Funding Acknowledgements Type of funding sources: None. Background Catheter ablation is the cornerstone for rhythm control in patients with drug-refractory atrial fibrillation (AF). Baseline predictors of AF recurrence after catheter ablation are well established, such as female gender and left atrial enlargement. The role of the spatial relationship between the left superior pulmonary vein (LSPV) and left atrial appendage (LAA) is unknown. Purpose We sought to evaluate whether juxtaposed LSPV and LAA plays a role in AF recurrence after catheter ablation for paroxysmal AF. Methods Consecutive patients, who underwent point-by-point radiofrequency catheter ablation for paroxysmal AF at our hospital between January of 2014 and December of 2017, were enrolled in the study. All patients underwent pre-procedural cardiac CT-angiography (CTA) for the assessment of left atrial (LA) and pulmonary vein (PV) anatomy. Abutting LAA-LSPV was defined as cases when LSPV touched the posterior aspect of LAA (distance less than 2 mm). Results We included 428 patients (60.7 ± 10.8 years, 35.5% female). AF recurrence rate was 33.4% with a median recurrence-free time of 21.2 (IQR = 8.8-43.0) months. In the univariate analysis, female sex (HR = 1.45; 95%CI = 1.04-2.01; p = 0.028), LA volume (HR = 1.01; 95%CI = 1.00-1.01; p = 0.042), and cases when LSPV touched the posterior wall of LAA (HR = 1.53; 95%CI = 1.09-2.14; p = 0.013) were associated with AF recurrence. In the multivariate analysis, female sex (adjusted HR = 1.55; 95%CI = 1.06-2.28; p = 0.024), LA volume (adjusted HR = 1.01; 95%CI = 1.00-1.02; p = 0.028), and abutting LAA-LSPV (adjusted HR = 1.60; 95%CI = 1.13-2.50; p = 0.008) remained significant predictors of AF recurrence. Conclusion Female gender, higher LA volume, and abutting LSPV and LAA predispose patients to have a higher chance for arrhythmia recurrence after catheter ablation for paroxysmal AF.

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