Pulmonary vein ablation in a patient with a large left common pulmonary vein joining a large right common trunk

摘要

We report the findings of a 57-year-old patient who was referred to our hospital with recurrent episodes of symptomatic persistent atrial fibrillation (AF). An electrocardiogram-triggered contrast-enhanced cardiac computer tomography (SOMATOMVR Definition Flash, Siemens) was performed before the procedure to integrate left atrial anatomy into the electroanatomic mapping system (CARTOVR 3 Merge, Biosense Webster, USA). The computed tomography (CT) revealed a highly unusual, previously unreported pulmonary vein (PV) variant consisting of a large left common PV (LCPV) joining a large right common PV trunk which separates into a right superior pulmonary vein (RSPV) and right inferior pulmonary vein (RIPV), as well as an accessory right PV (Figure 1 and Supplementary material).