Pulmonary vein morphology in atrial fibrillation patients before and after radiofrequency ablation

Objective: To study the morphological changes of pulmonary vein after circumferential pulmonary vein ablation (CPVA) for atrial fibrillation (AF) by using CT three-dimensional imaging technique. Methods: During the period form May 2008 to July 2011 at authors' hospital, CPVA was carried out in 24 patients with AF. 64-slice spiral CT scanning of the heart was performed. The changes of pulmonary vein morphology 3-6 months after CPVA were evaluated and were compared with the preoperative morphologic findings. Results: After the treatment, the maximum diameter of the left upper pulmonary vein, the minimum diameter of the right lower pulmonary vein and the cross-section area of the left upper pulmonary vein showed no statistically significant changes when compared with those determined before CPVA (P > 0.05). But statistically significant differences in the maximum diameter, the minimum diameter and the cross-section area of the other pulmonary veins existed between the preoperative data and postoperative ones (P < 0.05). The roundness of the pulmonary vein mouth determined after CPVA was significantly different from the preoperative one (P < 0.05). The differences in pulmonary vein mouth parameters,pulmonary vein index and the roundness of pulmonary vein mouth between preoperative and postoperative data were not significant (P > 0.05). No significant difference in pulmonary vein mouth parameters existed between male and female patients (P > 0.05). Of the 24 patients, three branches variation of the right pulmonary vein was up to 21%, while three branches variation of the left pulmonary vein was 4%. Conclusion: In patients with AF the pulmonary vein, being the same as the left atrium, has also anatomic reconstruction, which can be reversed after CPVA. In the variations of pulmonary vein mouth the variations of right pulmonary vein mouth is most commonly seen. (authors)