Acknowledgement
The authors acknowledge all the anonymous donors of the cadaveric hearts used for this study.
References
- Dudkiewicz D, Slodowska K, Jasinska KA, Dobrzynski H, Holda MK. The clinical anatomy of the left atrial structures used as landmarks in ablation of arrhythmogenic substrates and cardiac invasive procedures. Transl Res Anat 2021;23:100102. https://doi.org/10.1016/j.tria.2020.100102
- Cho KH, Kim JH, Murakami G, Abe H, Rodriguez-Vazquez JF, Chai OH. Nerve distribution in myocardium including the atrial and ventricular septa in late stage human fetuses. Anat Cell Biol 2019;52:48-56. https://doi.org/10.5115/acb.2019.52.1.48
- Belley-Cote EP, Connolly SJ, Whitlock RP. Left atrial appendage occlusion during cardiac surgery to prevent stroke. Reply. N Engl J Med 2021;385:1054-55.
- Ciuk S, Janas P, Klimek-Piotrowska W. Clinical anatomy of human heart atria and interatrial septum - anatomical basis for interventional cardiologists and electrocardiologists. Part 2: left atrium. Kardiol Pol 2018;76:510-9. https://doi.org/10.5603/KP.a2018.0001
- Hauser TH, Essebag V, Baldessin F, McClennen S, Yeon SB, Manning WJ, Josephson ME. Prognostic value of pulmonary vein size in prediction of atrial fibrillation recurrence after pulmonary vein isolation: a cardiovascular magnetic resonance study. J Cardiovasc Magn Reson 2015;17:49.
- Pappone C, Rosanio S, Oreto G, Tocchi M, Gugliotta F, Vicedomini G, Salvati A, Dicandia C, Mazzone P, Santinelli V, Gulletta S, Chierchia S. Circumferential radiofrequency ablation of pulmonary vein ostia: a new anatomic approach for curing atrial fibrillation. Circulation 2000;102:2619-28. https://doi.org/10.1161/01.CIR.102.21.2619
- Shi Y, Mi S, Shi Y, Wang H, Li J, Yu B, Liu F, Ma H, Wang B. Evaluation of pulmonary vein anatomy using 256-slice computed tomography. Turk J Med Sci 2017;47:1526-34. https://doi.org/10.3906/sag-1506-84
- Mulder BA, Al-Jazairi MIH, Arends BKO, Bax N, Dijkshoorn LA, Sheikh U, Tan ES, Wiesfeld ACP, Tieleman RG, Vliegenthart R, Rienstra M, van Gelder IC, Blaauw Y. Pulmonary vein anatomy addressed by computed tomography and relation to success of second-generation cryoballoon ablation in paroxysmal atrial fibrillation. Clin Cardiol 2019;42:438-43. https://doi.org/10.1002/clc.23163
- Ho SY, Anderson RH, Sanchez-Quintana D. Atrial structure and fibres: morphologic bases of atrial conduction. Cardiovasc Res 2002;54:325-36. https://doi.org/10.1016/S0008-6363(02)00226-2
- Marom EM, Herndon JE, Kim YH, McAdams HP. Variations in pulmonary venous drainage to the left atrium: implications for radiofrequency ablation. Radiology 2004;230:824-9. https://doi.org/10.1148/radiol.2303030315
- Klimek-Piotrowska W, Holda MK, Piatek K, Koziej M, Holda J. Normal distal pulmonary vein anatomy. PeerJ 2016;4:e1579.
- Kaseno K, Tada H, Koyama K, Jingu M, Hiramatsu S, Yokokawa M, Goto K, Naito S, Oshima S, Taniguchi K. Prevalence and characterization of pulmonary vein variants in patients with atrial fibrillation determined using 3-dimensional computed tomography. Am J Cardiol 2008;101:1638-42. Erratum in: Am J Cardiol 2008;102:508.
- Aktan Ikiz ZA, Ucerler H, Ozgur T. Anatomic characteristics of left atrium and openings of pulmonary veins. Anadolu Kardiyol Derg 2014;14:674-8. https://doi.org/10.5152/akd.2014.4968
- L C P, R P, D'Souza AS, Bhat KM. Variations in the pulmonary venous ostium in the left atrium and its clinical importance. J Clin Diagn Res 2014;8:10-1.
- Wei W, Ge JB, Zou Y, Lin L, Cai Y, Liu XB, Zhu WQ. Anatomical characteristics of pulmonary veins for the prediction of postoperative recurrence after radiofrequency catheter ablation of atrial fibrillation. PLoS One 2014;9:e93817.
- Gebhard C, Krasniqi N, Stahli BE, Klaeser B, Fuchs TA, Ghadri JR, Haegeli L, Luscher TF, Kaufmann PA, Duru F. Characterization of pulmonary vein dimensions using high-definition 64-slice computed tomography prior to radiofrequency catheter ablation for atrial fibrillation. Cardiol Res Pract 2014;2014:179632.
- Scharf C, Sneider M, Case I, Chugh A, Lai SW, Pelosi F Jr, Knight BP, Kazerooni E, Morady F, Oral H. Anatomy of the pulmonary veins in patients with atrial fibrillation and effects of segmental ostial ablation analyzed by computed tomography. J Cardiovasc Electrophysiol 2003;14:150-5. https://doi.org/10.1046/j.1540-8167.2003.02444.x
- Bittner A, Monnig G, Vagt AJ, Zellerhoff S, Wasmer K, Kobe J, Pott C, Milberg P, Sauerland C, Wessling J, Eckardt L. Pulmonary vein variants predispose to atrial fibrillation: a casecontrol study using multislice contrast-enhanced computed tomography. Europace 2011;13:1394-400. https://doi.org/10.1093/europace/eur145
- Kubala M, Hermida JS, Nadji G, Quenum S, Traulle S, Jarry G. Normal pulmonary veins anatomy is associated with better AF-free survival after cryoablation as compared to atypical anatomy with common left pulmonary vein. Pacing Clin Electrophysiol 2011;34:837-43. https://doi.org/10.1111/j.1540-8159.2011.03070.x
- Ronsoni RM, Silvestrini TL, Saffi MAL, Leiria TLL. Impact of the left common ostium following pulmonary vein isolation in AF: systematic review and meta-analysis. J Arrhythm 2022;38:287-98. https://doi.org/10.1002/joa3.12710
- Guler E, Guler GB, Demir GG, Kizilirmak F, Gunes HM, Barutcu I, Kilicaslan F. Effect of pulmonary vein anatomy and pulmonary vein diameters on outcome of cryoballoon catheter ablation for atrial fibrillation. Pacing Clin Electrophysiol 2015;38:989-96. https://doi.org/10.1111/pace.12660
- Baran J, Piotrowski R, Sikorska A, Kowalik I, Krynski T, Sebastian S, Kulakowski P. Impact of pulmonary vein ostia anatomy on efficacy of cryoballoon ablation for atrial fibrillation. Heart Beat J 2016;1:65-70. https://doi.org/10.24255/hbj/68162
- Coutino HE, Takarada K, Sieira J, Abugattas JP, Salghetti F, De Regibus V, Stroker E, Brugada P, Iacopino S, de Asmundis C, Chierchia GB. Anatomical and procedural predictors of pulmonary vein stenosis in the setting of second-generation cryoballoon ablation. J Cardiovasc Med (Hagerstown) 2018;19:290-6. https://doi.org/10.2459/JCM.0000000000000646
- Narui R, Tokuda M, Matsushima M, Isogai R, Tokutake K, Yokoyama K, Hioki M, Ito K, Tanigawa SI, Yamashita S, Inada K, Shibayama K, Matsuo S, Miyanaga S, Sugimoto K, Yoshimura M, Yamane T. Incidence and factors associated with the occurrence of pulmonary vein narrowing after cryoballoon ablation. Circ Arrhythm Electrophysiol 2017;10:e004588.
- Arentz T, Jander N, von Rosenthal J, Blum T, Furmaier R, Gornandt L, Josef Neumann F, Kalusche D. Incidence of pulmonary vein stenosis 2 years after radiofrequency catheter ablation of refractory atrial fibrillation. Eur Heart J 2003;24:963-9. https://doi.org/10.1016/S0195-668X(03)00002-2
- Takami M, Lehmann HI, Misiri J, Parker KD, Sarmiento RI, Johnson SB, Packer DL. Impact of freezing time and balloon size on the thermodynamics and isolation efficacy during pulmonary vein isolation using the second generation cryoballoon. Circ Arrhythm Electrophysiol 2015;8:836-45. https://doi.org/10.1161/CIRCEP.115.002725
- Schmidt M, Dorwarth U, Straube F, Daccarett M, Rieber J, Wankerl M, Krieg J, Leber AW, Ebersberger U, Huber A, Rummeny E, Hoffmann E. Cryoballoon in AF ablation: impact of PV ovality on AF recurrence. Int J Cardiol 2013;167:114-20. https://doi.org/10.1016/j.ijcard.2011.12.017
- Skowerski M, Wozniak-Skowerska I, Hoffmann A, Nowak S, Skowerski T, Sosnowski M, Wnuk-Wojnar AM, Mizia-Stec K. Pulmonary vein anatomy variants as a biomarker of atrial fibrillation - CT angiography evaluation. BMC Cardiovasc Disord 2018;18:146.
- Chen J, Yang ZG, Xu HY, Shi K, Long QH, Guo YK. Assessments of pulmonary vein and left atrial anatomical variants in atrial fibrillation patients for catheter ablation with cardiac CT. Eur Radiol 2017;27:660-70. https://doi.org/10.1007/s00330-016-4411-6
- Yokoyama K, Tokuda M, Matsuo S, Isogai R, Tokutake K, Kato M, Narui R, Tanigawa S, Yamashita S, Inada K, Yoshimura M, Yamane T. Pulmonary vein re-mapping after cryoballoon ablation for atrial fibrillation. Europace 2018;20:943-8. https://doi.org/10.1093/europace/eux129
- Chierchia GB, Sorgente A, Sarkozy A, de Asmundis C, Brugada P. The use of cryoballoon ablation in atrial fibrillation: simplifying pulmonary vein isolation? J Atr Fibrillation 2010;3:294.