Variability of pulmonary vein anatomy in patients ablated for atrial fibrillation

From January 2003 to February 2005, 30 consecutive patients (mean age 54±8.7 years, 27 male, 3 female) waiting for a catheter ablation of atrial fibrillation underwent gadolinium-enhanced magnetic resonance imaging (MRI) before the procedure. Variant pulmonary vein anatomy was observed in 12 (40%) of patients. The most frequent was a common left trunk (5 patients). Right middle pulmonary vein was observed in 4 cases, two right middle pulmonary veins in 2 cases and a common right trunk in 2 cases. One patient showed a common right trunk together with a common left trunk. Our study demonstrates the high frequency of variant pulmonary vein anatomy in the general population and demonstrates the value of MRI in facilitating catheter ablation of atrial fibrillation. Potentials benefits of obtaining preprocedural MRI include the ability to quantitatively evaluate the number, size, and shape of the pulmonary veins and the eventual choice of alternative mapping or ablation tools.