Wei Zhaoyang, Gong Linan, Wang Zanzan, Zuo Zheng, Zhang Zhiguo
Department of Cardiology The First Hospital of Jilin University Changchun Jilin China.
Clin Case Rep. 2024 Dec 31;13(1):e70042. doi: 10.1002/ccr3.70042. eCollection 2025 Jan.
Pulmonary vein anatomical variations are frequently observed in atrial fibrillation patients undergoing catheter ablation. However, when it comes to patients with atrial fibrillation and bilateral common ostium in the inferior pulmonary veins, using a bilateral circumferential pulmonary vein isolation approach during catheter ablation heightens the risk of esophageal injury. At present, there is no established standard catheter ablation strategy for such cases. A 47-year-old female with atrial fibrillation underwent catheter ablation. Prior to the procedure, a left atrial computed tomography angiography indicated a common ostium of the left and right inferior pulmonary veins. During mapping, a low-voltage area was found in the patient's left atrial posterior wall. To avoid esophageal injury and effectively isolate both pulmonary veins and the low-voltage area with minimal ablation points, we used a single-ring ablation approach. In a 12 month follow-up, the patient had no atrial fibrillation recurrence.
在接受导管消融的心房颤动患者中，经常观察到肺静脉解剖变异。然而，对于患有心房颤动且下肺静脉存在双侧共同开口的患者，在导管消融期间采用双侧肺静脉环形隔离方法会增加食管损伤的风险。目前，针对此类病例尚无既定的标准导管消融策略。一名47岁的心房颤动女性患者接受了导管消融。在手术前，左心房计算机断层血管造影显示左、右下肺静脉存在共同开口。在标测过程中，在患者左心房后壁发现了一个低电压区。为避免食管损伤并以最少的消融点有效隔离肺静脉和低电压区，我们采用了单环消融方法。在12个月的随访中，该患者未出现心房颤动复发。
