“Electrically Silent” Pulmonary Veins Connecting to the Right Atrium: Does the Atrium Make the Difference?


  • Disclosures: Drs. Steven, Rostock, and Willems report having received lecture honoraria from St. Jude Medical, St. Paul, MN, USA. Dr. Salukhe did receive a British Heart Foundation grant. Dr. Müllerleile reports no conflicts of interest.

Address for reprints: Daniel Steven, M.D., Department of Electrophysiology, University Hospital Hamburg- Eppendorf, Martinistr. 52, Hamburg 20246, Germany. Fax: 49-0-40-42803-4125; e-mail: d.steven@uke.uni-hamburg.de


Pulmonary veins (PVs) usually drain into the left atrium (LA) and are frequently targeted for electrical isolation, since it became evident that PVs may trigger and maintain paroxysmal atrial fibrillation (AF). We present a patient with right-sided PVs anomalously connecting to the right atrium with lack of electrical PV-atrial connection. Therefore, isolation of the left veins was performed resulting in freedom from AF as shown during a midterm follow-up. These findings indicate that PV connection to the LA may be a prerequisite for the arrhythmogenic properties of the PVs causing AF. (PACE 2010; 1–4)