Type:
Educational Exhibit
Keywords:
Computer Applications-Detection, diagnosis, CT-Angiography, CT, Cardiovascular system, Cardiac, Education and training
Authors:
P. ARGYRIOU1, G. Petrocheilou2, S. Velitsista3, G. ANYFANTAKIS1, A. Manginas1, C. Xenophon1, G. Kanoupakis1; 1Athens/GR, 2Alimos, Athens/GR, 3Haidari-Athens/GR
DOI:
10.1594/ecr2016/C-1969
Background
Atrial fibrillation (AF) is the most common cardiac rhythm disturbance and its major complication is the formation of atrial thrombi.
It has been discovered that paroxysms of AF are initiated by foci of spontaneous activity originating from the pulmonary veins in 90% of patients,
with almost half arising in the left superior pulmonary vein.
In most individuals sleeves of the left atrial myocardium extend into the pulmonary veins for a distance of 1-16mm.
These arrhythmogenic foci are an important cause of both paroxysmal and persistent AF.
Electric isolation of the pulmonary veins (PV) has become a central tenet in ablation strategies for AF.
Radiofrequency energy is ideally applied very close to the venoatrial junction.
Although most patients have standard pulmonary venous anatomy,
a minority of the population demonstrates variation in the size,
number and orientation of PVs.
The knowledge of PVs’ variability is of clinical importance to the electrophysiologist performing the left atrium (LA) ablation in order to reduce the risk of post ablation stenosis of the PVs’ ostium and the possibility of remaining ectopic foci.