A catheter ablation case of confluent inferior and left superior pulmonary veins: a rare pulmonary vein variation

Pulmonary vein (PV) variations are commonly detected by preoperative imaging modalities in catheter ablation for atrial fibrillation. However, rare variations that have not been previously reported exist. The present case is the first reported instance of three PVs originating from a common trunk. Contrast-enhanced cardiac computed tomography revealed that the left superior, left inferior, and right inferior PVs originated from the common trunk. Additionally, 3-dimensional electroanatomical mapping revealed interesting findings, showing that the three PVs and their common trunk were scarred areas prior to catheter ablation. The rare common PV may have no arrhythmogenic substrate in the PV antrum or common trunk.