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  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">97</journal-id>
      <journal-id journal-id-type="index">urn:lsid:arphahub.com:pub:B5033382-9D21-53CE-B630-B4E3A1146D51</journal-id>
      <journal-title-group>
        <journal-title xml:lang="en">Bulgarian Cardiology</journal-title>
        <abbrev-journal-title xml:lang="en">Bulgarian Cardiology</abbrev-journal-title>
      </journal-title-group>
      <issn pub-type="ppub">1310-7488</issn>
      <issn pub-type="epub">2683-1015</issn>
      <publisher>
        <publisher-name>Bulgarian Society of Cardiology</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="doi">10.3897/bgcardio.27.e71311</article-id>
      <article-id pub-id-type="publisher-id">71311</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Research Article</subject>
        </subj-group>
        <subj-group subj-group-type="scientific_subject">
          <subject>Arrhythmias (аритмии)</subject>
          <subject>Cardiovascular Imaging (сърдечно-съдови образни изследвания)</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Anatomic variants of pulmonary venous drainage and their relation to recurrences of atrial fibrillation after pulmonary vein isolation</article-title>
      </title-group>
      <contrib-group content-type="authors">
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Dineva</surname>
            <given-names>Svetla</given-names>
          </name>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Stoyanov</surname>
            <given-names>Milko</given-names>
          </name>
          <uri content-type="orcid">https://orcid.org/0000-0002-1226-6119</uri>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Partenova</surname>
            <given-names>Aneliya</given-names>
          </name>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Kunev</surname>
            <given-names>Boyan</given-names>
          </name>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Stoyanova</surname>
            <given-names>Victoria</given-names>
          </name>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="yes">
          <name name-style="western">
            <surname>Shalganov</surname>
            <given-names>Tchavdar</given-names>
          </name>
          <email xlink:type="simple">t_shalganov@yahoo.com</email>
          <uri content-type="orcid">https://orcid.org/0000-0003-2268-0759</uri>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
      </contrib-group>
      <aff id="A1">
        <label>1</label>
        <addr-line content-type="verbatim">National Heart Hospital, Sofia, Bulgaria</addr-line>
        <institution>National Heart Hospital</institution>
        <addr-line content-type="city">Sofia</addr-line>
        <country>Bulgaria</country>
      </aff>
      <author-notes>
        <fn fn-type="corresp">
          <p>Corresponding author: Tchavdar Shalganov (<email xlink:type="simple">t_shalganov@yahoo.com</email>).</p>
        </fn>
        <fn fn-type="edited-by">
          <p>Academic editor: Kameliya Genova</p>
        </fn>
      </author-notes>
      <pub-date pub-type="collection">
        <year>2021</year>
      </pub-date>
      <pub-date pub-type="epub">
        <day>18</day>
        <month>10</month>
        <year>2021</year>
      </pub-date>
      <volume>27</volume>
      <issue>3</issue>
      <fpage>55</fpage>
      <lpage>68</lpage>
      <uri content-type="arpha" xlink:href="http://openbiodiv.net/734E7E18-4CF8-5B24-948B-95221772A859">734E7E18-4CF8-5B24-948B-95221772A859</uri>
      <uri content-type="zenodo_dep_id" xlink:href="https://zenodo.org/record/5598639">5598639</uri>
      <history>
        <date date-type="received">
          <day/>
          <month/>
          <year/>
        </date>
      </history>
      <permissions>
        <copyright-statement>Svetla Dineva, Milko Stoyanov, Aneliya Partenova, Boyan Kunev, Victoria Stoyanova, Tchavdar Shalganov</copyright-statement>
        <license license-type="creative-commons-attribution" xlink:href="http://creativecommons.org/licenses/by/4.0/" xlink:type="simple">
          <license-p>This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p>
        </license>
      </permissions>
      <abstract>
        <label>Abstract</label>
        <p>Anatomical variants of pulmonary venous drainage in the left atrium are often found. Divergent results have been reported on the impact of variant anatomy on atrial ﬁ brillation (AF) recurrence after catheter ablation. We aimed to study the frequency of different anatomical variants of pulmonary venous drainage and their relationship with documented recurrences of AF after ablation. <bold>Material and methods: </bold>A retrospective study of patients with AF in whom radiofrequency pulmonary vein isolation was done after previously performed cardiac contrast-enhanced multidetector computed tomography. Clinical and procedural characteristics, type and frequency of anatomical variants of the veno-atrial junction and their association with AF recurrences were studied. <bold>Results: </bold>One hundred seventy-seven patients (112 men, 63.3%) with AF were studied, of which 148 (83.6%) with paroxysmal AF. Variant anatomy was found in 91 patients (51.4%). In 20.9% there was a common left trunk, in 23.2% – more or less than two right-sided veins, and in 7.3% – variations for both right and left veins. No differences in clinical and procedural characteristics were found between the groups with normal and variant anatomy. Recurrences of AF and their association with pulmonary venous anatomy were studied in 104 patients with follow-up ≥ 3 months. No signiﬁ cant relation was found between the presence of variant anatomy and AF recurrences within the blinding period after ablation, OR = 0.864, 95% CI = 0.397 – 1.88, p = 0.843, nor afterwards, OR = 1.12, 95% CI = 0.5 – 2.5, p = 0.839. Cox regression analysis showed no differences in AF recurrence-free survival regardless of the anatomical variant of pulmonary venous drainage, HR = 1.09, 95% CI = 0.58 – 2.05, p = 0.779. <bold>Conclusion: </bold>In this local population of patients with AF, the incidence of variant pulmonary venous drainage is just over 50%. No association was found between variant anatomy and the rate of AF recurrences after ﬁ rst pulmonary vein isolation.</p>
      </abstract>
    </article-meta>
  </front>
</article>
