Department of Cardiology, International University Health and Welfare Hospital, Nasushiobara, Japan.
Department of Radiology, International University Health and Welfare Hospital, Nasushiobara, Japan.
Pacing Clin Electrophysiol. 2022 May;45(5):598-604. doi: 10.1111/pace.14476. Epub 2022 Apr 20.
A left common pulmonary vein (LCPV) is the most common anatomical variation in the pulmonary vein (PV) and often influences strategies of PV isolation for atrial fibrillation (AF). Our objective was to elucidate the electrical properties of the specific shape of LCPV and to apply it to an ablation procedure.
We investigated consecutive 12 out of 204 paroxysmal AF patients who had the shape of a straight common trunk in LCPV defined by the formation of a single conduit with parallel cranial and caudal walls after the coalescence of superior and inferior PVs on the distal side. The distance between the top of the bifurcation of LPVs and the level coinciding with the middle of the anterior wall of LCPV (left lateral ridge: LLR) was more than 10 mm in all the patients. The activation pattern of the LLR showed longitudinal conduction without outside connections. All the LCPV except one were successfully isolated without ablating the LLR (C-shape ablation). Only one patient had AF recurrence during the follow-up period.
The LLR in LCPV with a straight common trunk has longitudinal conduction without outside connections, which permits the isolation of LCPV without ablating LLR.
左肺静脉共干（LCPV）是肺静脉（PV）中最常见的解剖变异，通常会影响到房颤（AF）的 PV 隔离策略。我们的目的是阐明 LCPV 特定形状的电生理特性，并将其应用于消融程序中。
我们对连续的 204 例阵发性 AF 患者中的 12 例进行了研究，这些患者的 LCPV 呈直的共同干状，在上下 PV 融合于远端后形成单一的管腔，其前后壁平行。LPV 分叉的顶部和 LCPV 前壁中部（左侧外侧嵴：LLR）重合处的距离在所有患者中均大于 10mm。LLR 的激活模式呈纵向传导，无外部连接。除了 1 例患者之外，所有的 LCPV 均未消融 LLR 而成功地被隔离（C 形消融）。只有 1 例患者在随访期间出现 AF 复发。
具有直共同干的 LCPV 中的 LLR 具有纵向传导而无外部连接，这使得 LCPV 的隔离无需消融 LLR。
