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KEY FACTS
Terminology
Imaging
Clinical Issues
TERMINOLOGY
Definitions
Pulmonary veins drain oxygenated blood from lungs into left atrium
Electrical foci inside pulmonary veins may trigger atrial fibrillation, a common arrhythmia
Catheter-based pulmonary vein isolation is widespread treatment for atrial fibrillation
Pulmonary vein anatomy is important to guide ablation procedures
Normal pulmonary vein anatomy: 2 left and 2 right pulmonary veins drain into left atrium
Variants of pulmonary vein anatomy are common and include supernumerary veins draining into left atrium or single ostia for left or right pulmonary veins
Anomalies of pulmonary veins are defined as any pattern where pulmonary veins drain into structures other than left atrium [most frequently inferior vena cava (IVC), right atrium, or superior vena cava]
Scimitar syndrome is infrequent pulmonary vein anomaly where pulmonary veins from right middle and lower lobe drain into IVC or right atrium
IMAGING
General Features
Echocardiographic Findings
Angiographic Findings
CT Findings
MR Findings
Imaging Recommendations
CLINICAL ISSUES
Presentation
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
Mulder BA et al: Pulmonary vein anatomy addressed by computed tomography and relation to success of second-generation cyroballoon ablation in paroxysmal atrial fibrillation. Clin Cardiol. ePub, 2019
Fender EA et al: Assessment and management of pulmonary vein occlusion after atrial fibrillation ablation. JACC Cardiovasc Interv. 11(16):1633-9, 2018
Merchant FM et al: Pulmonary vein anatomy assessed by cardiac magnetic resonance imaging in patients undergoing initial atrial fibrillation ablation: implications for novel ablation technologies. J Interv Card Electrophysiol. 46(2):89-96, 2016
Tsyganov A et al: Anatomical predictors for successful pulmonary vein isolation using balloon-based technologies in atrial fibrillation. J Interv Card Electrophysiol. 44(3):265-71, 2015
den Uijl DW et al: Effect of pulmonary vein anatomy and left atrial dimensions on outcome of circumferential radiofrequency catheter ablation for atrial fibrillation. Am J Cardiol. 107(2):243-9, 2011
Rajiah P et al: Computed tomography of pulmonary venous variants and anomalies. J Cardiovasc Comput Tomogr. 4(3):155-63, 2010
Kaseno K et al: Prevalence and characterization of pulmonary vein variants in patients with atrial fibrillation determined using 3-dimensional computed tomography. Am J Cardiol. 101(11):1638-42, 2008. Erratum in: Am J Cardiol. 102(4):508, 2008
Lacomis JM et al: CT of the pulmonary veins. J Thorac Imaging. 22(1):63-76, 2007
Marom EM et al: Variations in pulmonary venous drainage to the left atrium: implications for radiofrequency ablation. Radiology. 230(3):824-9, 2004
Lacomis JM et al: Multi-detector row CT of the left atrium and pulmonary veins before radio-frequency catheter ablation for atrial fibrillation. Radiographics. 23 Spec No:S35-48; discussion S48-50, 2003
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Clinical Issues
TERMINOLOGY
Definitions
Pulmonary veins drain oxygenated blood from lungs into left atrium
Electrical foci inside pulmonary veins may trigger atrial fibrillation, a common arrhythmia
Catheter-based pulmonary vein isolation is widespread treatment for atrial fibrillation
Pulmonary vein anatomy is important to guide ablation procedures
Normal pulmonary vein anatomy: 2 left and 2 right pulmonary veins drain into left atrium
Variants of pulmonary vein anatomy are common and include supernumerary veins draining into left atrium or single ostia for left or right pulmonary veins
Anomalies of pulmonary veins are defined as any pattern where pulmonary veins drain into structures other than left atrium [most frequently inferior vena cava (IVC), right atrium, or superior vena cava]
Scimitar syndrome is infrequent pulmonary vein anomaly where pulmonary veins from right middle and lower lobe drain into IVC or right atrium
IMAGING
General Features
Echocardiographic Findings
Angiographic Findings
CT Findings
MR Findings
Imaging Recommendations
CLINICAL ISSUES
Presentation
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
Mulder BA et al: Pulmonary vein anatomy addressed by computed tomography and relation to success of second-generation cyroballoon ablation in paroxysmal atrial fibrillation. Clin Cardiol. ePub, 2019
Fender EA et al: Assessment and management of pulmonary vein occlusion after atrial fibrillation ablation. JACC Cardiovasc Interv. 11(16):1633-9, 2018
Merchant FM et al: Pulmonary vein anatomy assessed by cardiac magnetic resonance imaging in patients undergoing initial atrial fibrillation ablation: implications for novel ablation technologies. J Interv Card Electrophysiol. 46(2):89-96, 2016
Tsyganov A et al: Anatomical predictors for successful pulmonary vein isolation using balloon-based technologies in atrial fibrillation. J Interv Card Electrophysiol. 44(3):265-71, 2015
den Uijl DW et al: Effect of pulmonary vein anatomy and left atrial dimensions on outcome of circumferential radiofrequency catheter ablation for atrial fibrillation. Am J Cardiol. 107(2):243-9, 2011
Rajiah P et al: Computed tomography of pulmonary venous variants and anomalies. J Cardiovasc Comput Tomogr. 4(3):155-63, 2010
Kaseno K et al: Prevalence and characterization of pulmonary vein variants in patients with atrial fibrillation determined using 3-dimensional computed tomography. Am J Cardiol. 101(11):1638-42, 2008. Erratum in: Am J Cardiol. 102(4):508, 2008
Lacomis JM et al: CT of the pulmonary veins. J Thorac Imaging. 22(1):63-76, 2007
Marom EM et al: Variations in pulmonary venous drainage to the left atrium: implications for radiofrequency ablation. Radiology. 230(3):824-9, 2004
Lacomis JM et al: Multi-detector row CT of the left atrium and pulmonary veins before radio-frequency catheter ablation for atrial fibrillation. Radiographics. 23 Spec No:S35-48; discussion S48-50, 2003
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