Left Atrial Roof Vein

Pre operative three dimensional computed tomography revealed a unique left atrial la roof vein.

Left atrial roof vein.

Clinical centers employ different ablation strategies which use imaging data together with electroanatomic mapping data depending on data availability. During cardiac development the oblique vein of the left atrium vein of marshall passes from a superior aspect onto the epicardial surface of the left atrium in between the left atrial appendage and the left superior pulmonary vein to descend along the posterolateral atrial wall to join the coronary sinus figure 2 b. The ablation strategy consisted of liner ablations including the roof bottom and mitral isthmus as well as pulmonary vein isolation. J am coll cardiol.

Ethanol infusion of 5 ml into the marshall vein was performed prior to pulmonary vein isolation while locating the advisortm hd grid mapping catheter abbott. Electrophysiological findings showed expansion of the myocardial sleeve and local firing in the la. Pulmonary vein pv reconnection is mainly due to nontransmural ablation and is considered a major determinant of atrial fibrillation af recurrence after pulmonary vein isolation pvi several technologies have been developed in an attempt to improve radiofrequency rf lesion transmurality and pvi durability such as irrigated tip ablation catheters and real time contact. However there are conflicting data on the effects of creating a roof line rl joining the superior pvs in paroxysmal atrial fibrillation paf.

Catheter ablation therapy for persistent atrial fibrillation af typically includes pulmonary vein isolation pvi and may include additional ablation lesions that target patient specific anatomical electrical or structural features. Aberrant pulmonary vein draining to left atrial roof in a patient undergoing percutaneous circumferential pulmonary vein isolation pdf. Addition of linear ablation lesions principally in the atrial roof between the left and right superior pulmonary veins and mitral isthmus between the left inferior pulmonary vein and the mitral annulus led to improved success rates especially in patients with paroxysmal af and coexistent la enlargement 3 and in patients with persistent af 4. This vein ran from the right superior lobe of the lung to the left side of la roof.

A 64 year old man diagnosed with persistent atrial fibrillation underwent a first ablation process. Roles of the left atrial roof and pulmonary veins in the anatomic substrate for persistent atrial fibrillation and ablation in a canine model.