Learning objectives 1. To review the most relevant cardiac anatomy related to pulmonary veins Ablation (PVA) as a treatment option for cardiac arrhythmia. 2. To describe the MRI and CT techniques used for planning the procedure. 3. To identify the most common complications following the procedure by conventional radiography (CR), CT and MRI.

Background 1.- Topic review Atrial fibrillation Atrial fibrillation (AF) is the most frequent type of arrhythmia (1), with a prevalence of 0.4-1% that increases with age, reaching 8% in patients older tan 80 years old (2). It increases the risk of death, heart failure and stroke, of which one in six , occurs in a patient with AF.(3) Fig. 2 AF is treated with antiarrhythmic drugs and electric cardioversion. When these treatments are unsuccesful, AF lasts for more than 2 years, or there is a...

Findings and procedure details Planning prior to ablation is usually made with CT angiogram. 1.- Technique A.- CT angiogram. Acquisition for pulmonary veins study can be performed with prospective or retrospective synchronization, or with no synchronization (8). The main hindrance to retrospective synchronization is the high radiation dose administered to the patient. This dose can be reduced by lowering the kilovoltage (5, 9) Fig. 8 Non-synchronized acquisitions allow less radiation to the patient, but have limitations of its own (8). When heart rate is over...

Conclusions CT and MRI offers exquisite details of the cardiac and pulmonary venous anatomy allowing for precise planning of procedure to treat AF with PVA. The diagnosis of the post procedural complications demands specific knowledge of the anatomy of the region and understanding of the procedure carried out for the treatment. The TC overestimates PV stenosis and is crucial in handling.

References 1.- Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, et al. 2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 Guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in partnership with the European Society of Cardiology and in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. J Am Coll Cardiol. 2011 15;57:101-98. 2.- Go AS, Hylek EM, Phillips KA, Chang...