Dynamic Changes of Pulmonary Veins Ostia in Controls and Atrial Fibrillation Patients

The quantitative evaluation of pulmonary veins (PVs) contraction and its connection with atrial fibrillation (AF) have not yet been clearly defined. The purpose of this study was to investigate the variation of PVs ostial size using ECG-gated cardiac CECT (contrast enhanced computed tomography) as this modality may be useful for monitoring patients after PVs isolation procedures. Analysis was performed on 9 control (CTRL) patients, 9 paroxysmal AF (PAR) patients and 9 persistent AF (PER) patients (mean age $61\pm 10$ years, 23 males and 4 females). The left atrium (LA) anatomical model was reconstructed throughout the cardiac cycle and the PVs ostial area and their variation was obtained. As a result, the inferior veins were found to be the smallest on average, on the left side particularly, while the right superior vein was found to be the biggest. The same results were found for the PVs ostial area variation, which was the lowest for the inferior veins and the biggest for the right superior vein. Morphological and functional differences were found among the groups. AF patients had lower PVs ostial area variation compared to controls, highlighting a reduction in effectiveness in terms of passive filling and active contraction within the LA that makes the PVs ostia contracting less than in healthy subjects.