The ambiguous pulmonary venoatrial junction: A new perspective

Gabrielle P. Konin, Vineet R. Jain, John Devens Fisher, Linda B. Haramati

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose: The pulmonary venoatrial junction (PVAJ) has recently received attention due to the widespread use of catheter ablation for atrial fibrillation. However, the literature lacks a consensus in the definition of the PVAJ. We aim to review the inconsistent definitions for the PVAJ and related implications in imaging and catheter ablation for atrial fibrillation. Results: The PVAJ as described by embryology, gross anatomy, histology and imaging is ambiguous, leading to disparities in its definition. Because of differing definitions of the PVAJ, there is a broad range in the prevalence of anatomic variations, including (1) percentage of common pulmonary veins (10-79% on the left), (2) supernumerary pulmonary veins (10-42%) and (3) ostial diameter and shape. We postulate several reasons for this broad range in the described prevalence of anatomic variation of the PV as follows: (1) different definitions of the PVAJ, (2) different vantage points, (3) different imaging modalities, and (4) different prevalence of anatomic variants among different study populations. Conclusions: The ambiguous PVAJ with its gradual transition from the left atrium to the pulmonary veins defies precise definition even though it plays an important role in the management of atrial fibrillation. Physicians should be aware of variability in the language used to describe the PVAJ and resultant discrepancy in reported anatomical information.

Original languageEnglish (US)
Pages (from-to)433-443
Number of pages11
JournalInternational Journal of Cardiovascular Imaging
Volume24
Issue number4
DOIs
StatePublished - Apr 2008

Fingerprint

Lung
Pulmonary Veins
Atrial Fibrillation
Anatomic Variation
Catheter Ablation
Embryology
Heart Atria
Anatomy
Consensus
Histology
Language
Physicians
Population

Keywords

  • Ablation
  • Atrial fibrillation
  • Computed tomography (CT)
  • Pulmonary veins

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine
  • Radiological and Ultrasound Technology

Cite this

The ambiguous pulmonary venoatrial junction : A new perspective. / Konin, Gabrielle P.; Jain, Vineet R.; Fisher, John Devens; Haramati, Linda B.

In: International Journal of Cardiovascular Imaging, Vol. 24, No. 4, 04.2008, p. 433-443.

Research output: Contribution to journalArticle

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