Common pulmonary veins anatomic variants assesed by routine preprocedural multislice computed tomography angiography and its impact on success of atrial fibrillation ablation — single center experience in 75 cases

Background: Electrical pulmonary vein isolation (PVI) has become an effective tool to control atrial fibrillation (AF). Point by point ablation guided by electroanatomical mapping system is a preferable method of achieving it. Most electrophysiology (EP) labs routinely employ some kind of preprocedural imaging to gain insight into PV anatomical variants that could alter the strategy of ablation procedure. On the other hand there is scarce data on correlation of knowledge of pulmonary vein (PV) anatomy on success, duration and safety of the procedure. Methods: From November 2009 till March 2013 we performed 75 AF ablations in General Hospital Zadar, EP lab. All patients underwent preprocedural left atrial and pulmonary veins MSCT angiography using Siemens Somatom 16. 3D reconstructions were made with standard software and operators were aware of the anatomy. Patients were divided into 2 groups depending on anatomical variants of PVs: Group A -standard anatomy in whom all 4 PVs connect to LA with separated ostia and Group B -any other anatomical variant. We then correlated the anatomy with outcomes in terms of success, duration and safety of the ablation procedure.