Heist E Kevin, Holmvang Godtfred, Abbara Suhny, Ruskin Jeremy N, Mansour Moussa
Cardiac Arrhythmia Service.
Cardiology Division.
J Atr Fibrillation. 2008 Jul 16;1(2):13. doi: 10.4022/jafib.13. eCollection 2008 Jul-Aug.
Successful catheter ablation of atrial fibrillation (AF) requires a detailed understanding of left atrial anatomy in order to maximize the safety and efficacy of the procedure. Common and rare variants of left atrial and pulmonary venous anatomy have been described which can affect the optimal ablation strategy for each individual patient. These variants include the presence of a right or left middle pulmonary vein, a left or right common pulmonary vein, a common inferior pulmonary vein, a right top pulmonary vein, and other rare forms of anomalous pulmonary venous drainage. There are also important patient-specific differences in pulmonary venous ridges and left atrial roof morphology. Pre-procedural CT or MR imaging can define these anatomic variants in exquisite detail and be used with image-integration strategies to direct the ablation procedure. In this review, we describe common and uncommon variants that can be identified by pre-procedural imaging, and suggest ablation strategies tailored to these anatomic variants.
成功的心房颤动（AF）导管消融术需要详细了解左心房解剖结构，以最大限度地提高手术的安全性和有效性。已经描述了左心房和肺静脉解剖结构的常见和罕见变异，这些变异可能会影响每个患者的最佳消融策略。这些变异包括右或左中间肺静脉、左或右共同肺静脉、共同下肺静脉、右上肺静脉以及其他罕见形式的异常肺静脉引流。肺静脉嵴和左心房顶部形态在患者个体之间也存在重要差异。术前CT或MR成像可以非常详细地定义这些解剖变异，并与图像整合策略一起用于指导消融手术。在本综述中，我们描述了可通过术前成像识别的常见和不常见变异，并提出针对这些解剖变异的消融策略。
