Pulmonary vein myocardial sleeve

The pulmonary vein myocardium refers to extensions of atrial cardiac muscle tissue into the proximal portions of the pulmonary veins, forming “myocardial sleeves” several centimeters long. These sleeves are composed of specialized cardiac muscle capable of automaticity and triggered electrical activity, which contributes to their arrhythmogenic potential. Pulmonary vein myocardial sleeves are the primary anatomical source of ectopic electrical impulses that can initiate atrial fibrillation. The sleeves are targets for catheter ablation in the management of this arrhythmia. Developmentally, they derive from myocardial tissue differentiating at the connection between the common pulmonary vein and the left atrium, marked by expression of fast-conducting gap junction proteins (e.g., Cx40), and characterized by a lack of venous valves. They may also play a role in congenital anomalies of pulmonary venous return. While not a classic molecular drug target, pulmonary vein myocardium is a therapeutic target via interventional electrophysiological procedures[1][2][3][4].

Other names

pulmonary vein muscle sleeveatrial myocardial extension in pulmonary veinmyocardial sleeve of pulmonary vein

Ablation (catheter-based isolation or destruction of arrhythmogenic tissue to prevent ectopic electrical activity)