Abstract
BACKGROUND: The common inferior pulmonary vein (CIPV) is a rare anatomical variant that may complicate pulmonary vein isolation for atrial fibrillation (AF). We present tailored ablation strategies for AF patients with CIPV or CIPV-like anatomy. METHODS: Six AF patients with CIPV were retrospectively analyzed. Pre- or postprocedural computed tomography and/or three-dimensional mapping identified the anatomy. Ablation was guided by voltage mapping, with lesions delivered only at sites with electrical activity. RESULTS: Four patients had paroxysmal AF and 2 patients had persistent AF. The right superior and left superior pulmonary veins were isolated in all cases. CIPV was treated with limited ostial ablation (n = 4), complete trunk isolation (n = 1), or single-ring posterior wall isolation (n = 1). No acute complications occurred. Over a mean follow-up of 14.2 months, 5 of the 6 patients remained free from AF recurrence. CONCLUSIONS: Tailored ablation strategies based on imaging and voltage guidance allow safe and effective treatment of AF in patients with CIPV.