A common inferior pulmonary trunk detected by computed tomography affects atrial fibrillation ablation strategy

Pulmonary veins (PV) display a variety of anomalies with a common trunk of the inferior pulmonary veins being the most infrequent. We report on a 65-year-old man who underwent an ablation procedure for atrial fibrillation (AF) exclusively based on electro-anatomical mapping. After recurrence of AF, a common trunk of the inferior PV was detected by computed tomography imaging resulting in a modified ablation approach. Due to a possible role of the common inferior trunk for the initiation of AF, a repeat procedure was performed by en bloc isolation of the common inferior trunk with the left superior PV. The right superior PV was ablated separately. Off antiarrhythmic medication, the patient has remained free of any arrhythmia during a 14 month follow-up.