Idiopathic Atrial Fibrillation and Coronary Arteriovenous Fistulae: Is There a Link?

Cardiology ◽  
2016 ◽  
Vol 134 (4) ◽  
pp. 433-435 ◽  
Author(s):  
Hina K. Jamali ◽  
Umara Raza ◽  
Fahad Waqar
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Arrhythmias ◽  
Similar Case ◽  
Superior Vena ◽  
Vena Cava ◽  
Definitive Treatment ◽  
Arteriovenous Fistulae ◽  
Coronary Arteriovenous Fistula ◽  
The Right ◽  
New Onset

Despite being one of the most prevalent cardiac arrhythmias, the cause of atrial fibrillation (AF) in a vast majority of patients remains unknown. There is growing evidence of associated AF in patients diagnosed with coronary arteriovenous fistula. In this discussion, we have included an example of a patient who presented with new-onset AF and was subsequently diagnosed with an anomalous fistula between the right coronary artery and the superior vena cava. Definitive treatment of the fistula resulted in permanent resolution of the AF. Based on this case and a similar case reported in the literature, it is proposed that further research will unmask this possibly underdiagnosed and very treatable cause of AF.

Electrocardiography-controlled central venous catheter tip positioning in patients with atrial fibrillation

2018 ◽  
Vol 19 (6) ◽  
pp. 528-534 ◽  
Author(s):  
Folkert Steinhagen ◽  
Maximilian Kanthak ◽  
Guido Kukuk ◽  
Christian Bode ◽  
Andreas Hoeft ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Central Venous Catheter ◽  
Superior Vena ◽  
Vena Cava ◽  
Venous Catheter ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Catheter Tip ◽  
Tip Position ◽  
The Right

Introduction: A significant increase of the p-wave of a real-time intracavitary electrocardiography is a reliable and safe method to confirm the central venous catheter tip position close to the atrium. However, conflicting data about the feasibility of electrocardiography exist in patients with atrial fibrillation. Methods: An observational prospective case–control cohort study was set up to study the feasibility and accuracy of the electrocardiography-controlled central venous catheter tip placement in 13 patients with atrial fibrillation versus 10 patients with sinus rhythm scheduled for elective surgery. Each intervention was crosschecked with ultrasound-guided positioning via right supraclavicular fossa view and chest radiography. Ultrasound-guided supraclavicular venipuncture of the right subclavian vein and guidewire advancement were performed. A B-mode view of the superior vena cava and the right pulmonary artery was obtained to visualize the J-tip of the guidewire. The central venous catheter was advanced over the guidewire and the electrocardiography was derived from the J-tip of the guidewire protruding from the central venous catheter tip. Electrocardiography was read for increased p- and atrial fibrillation waves, respectively, and insertion depth was compared with the ultrasound method. Results: Electrocardiography indicated significantly increasing fibrillation and p-waves, respectively, in all patients and ultrasound-guided central venous catheter positioning confirmed a tip position within the lower third of the superior vena cava. Conclusion: Electrocardiography-guided central venous catheter tip positioning is a feasible real-time method for patients with atrial fibrillation. Combined with ultrasound, the electrocardiography-controlled central venous catheter placement may eliminate the need for postinterventional radiation exposure.

scholarly journals Results of radiofrequency ablation of ectopic atrial tachycardia originating from the left superior vena cava in a patient with congenital heart disease

2021 ◽  
Vol 28 (3) ◽  
pp. 67-72
Author(s):  
E. V. Lubkina ◽  
S. Yu. Serguladze ◽  
Zh. Kh. Tembotova ◽  
I. I. Maslova ◽  
V. G. Suladze ◽  
...  
Keyword(s):  
Superior Vena Cava ◽  
Cardiac Arrhythmias ◽  
Atrial Tachycardia ◽  
Congenital Heart ◽  
Superior Vena ◽  
Vena Cava ◽  
Left Superior Vena Cava ◽  
Ectopic Atrial Tachycardia ◽  
The Right ◽  
Dilated Coronary Sinus

Persistent left superior vena cava (PLSVC) is the most common anomaly of the thoracic veins (occurs in 0.2-0.6% of cases in the general population), in the vast majority of cases, PLSVC drains into the right atrium through the dilated coronary sinus and usually does not lead to significant hemodynamic disorders. The presence of PLSVC is often associated with cardiac arrhythmias; in this clinical case, we present the results of catheter ablation of arrhythmogenic foci in a 72-year-old patient with continuous-recurring ectopic tachycardia originating from the PLSVC.

scholarly journals Catheter ablation of atrial fibrillation without pulmonary vein isolation

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
P Futyma ◽  
L Zarebski ◽  
A Wrzos ◽  
M Futyma ◽  
P Kulakowski
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Superior Vena ◽  
Vena Cava ◽  
Funding Sources ◽  
The Right ◽  
Ganglionated Plexus

Abstract Funding Acknowledgements Type of funding sources: None. Background Pulmonary vein isolation (PVI) is a cornerstone for catheter ablation (CA) of atrial fibrillation (AF), however, long-term efficacy of PVI is frequently below expectations. PVI is invasive, expensive and may be associated with devastating complications. It has been postulated that vagally-mediated AF can be treated by attenuation of parasympathetic drive to the heart using cardioneuroablation by means of radiofrequency CA (RFCA) of the right anterior ganglionated plexus (RAGP), however, data in literature and guidelines are lacking. Purpose To examine the efficacy of RFCA targeting RAGP without PVI in management of vagal AF. Methods We included consecutive 9 male patients with vagal AF who underwent RFCA of RAGP without PVI. RAGP was targeted anatomically from the right atrium (RA) at the postero-septal area below superior vena cava (SVC) and from the left atrium (LA) if needed. The aim was to achieve >30% increase in heart rate (HR) . The follow up consisted of regular visits and Holter ECG conducted every 3 months. Results A total number of 9 patients (age 52 ± 13) with vagally-mediated AF underwent RFCA of RAGP (mean RAGP RF time 147 ± 85, max power 34 ± 8W). The mean procedure time was 60 ± 29min. HR increase >30% was achieved in 8 (89%) patients (pre-RF vs post-RF: 58 ± 8bpm vs 87 ± 12bpm, p = 0.00002) . Transseptal  to reach RAGP also from the LA was needed in 2 (22%) patients. There were no major complications during the procedures. The follow up lasted 6 ± 2 months. Antiarrhythmic drugs were discontinued in 8 (89%) patients. There was 1 (11%) AF recurrence in the patient in whom targeted HR acceleration during RFCA was not achieved. B-blockers were administered in  6 (67%) patients due to increased HR and such treatment was well tolerated by all. Conclusions Catheter ablation of RAGP without performing PVI is feasible and can be effective in majority of patients with vagally-mediated AF. Increased HR after such cardioneuroablation can be well controlled using b-blockers and is usually associated with mild symptoms. The role of cardioneuroablation for treatment of vagally-mediated AF needs to be determined in prospective trials. Abstract Figure. Cardioneuroablation in vagal AF

scholarly journals Electroanatomic Mapping and Catheter Ablation of Breakthroughs From the Right Atrium to the Superior Vena Cava in Patients With Atrial Fibrillation

Circulation ◽  
2002 ◽  
Vol 106 (11) ◽  
pp. 1317-1320 ◽  
Author(s):  
Masahiko Goya ◽  
Feifan Ouyang ◽  
Sabine Ernst ◽  
Marius Volkmer ◽  
Matthias Antz ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Superior Vena Cava ◽  
Right Atrium ◽  
Superior Vena ◽  
Vena Cava ◽  
Electroanatomic Mapping ◽  
The Right

Unusual malposition of a peripherally inserted central catheter into the left pericardiophrenic vein: A case report

2021 ◽  
pp. 112972982110189
Author(s):  
Alfonso Piano ◽  
Annamaria Carnicelli ◽  
Emanuele Gilardi ◽  
Nicola Bonadia ◽  
Kidane Wolde Sellasie ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Superior Vena ◽  
Vena Cava ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
X Ray ◽  
Bubble Test ◽  
Chest X Ray ◽  
The Right ◽  
Pericardiophrenic Vein

We report a case of primary malposition of a PICC inserted by guidewire replacement in the emergency room. Intraprocedural tip location by intracavitary electrocardiography was not feasible because the patient had atrial fibrillation; intraprocedural tip location by ultrasound (using the so-called “bubble test”) showed that the tip was not in the superior vena cava or in the right atrium. A post-procedural chest X-ray confirmed the malposition but could not precise the location of the tip. A CT scan (scheduled for other purposes) finally visualized the tip in a very unusual location, the left pericardiophrenic vein.

scholarly journals Is there a connection between the right upper pulmonary vein and the superior vena cava in patients with atrial fibrillation?

2002 ◽  
Vol 39 ◽  
pp. 110 ◽  
Author(s):  
Walid I. Saliba ◽  
Nassir Marrouche ◽  
David Martin ◽  
Krzysztof Balaban ◽  
Christopher Cole ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
The Right

Large congenital coronary arteriovenous fistula between the left main coronary artery and right superior vena cava, associated with aneurysmal dilatation of the left main coronary artery: rare case report

2014 ◽  
Vol 25 (1) ◽  
pp. 143-145 ◽  
Author(s):  
Naveen Chandra ◽  
Achyut Sarkar ◽  
Arindam Pande
Keyword(s):  
Coronary Artery ◽  
Arteriovenous Fistula ◽  
Superior Vena Cava ◽  
Left Main Coronary Artery ◽  
Superior Vena ◽  
Vena Cava ◽  
Left Main ◽  
Aneurysmal Dilatation ◽  
Coronary Arteriovenous Fistula ◽  
The Right

AbstractCoronary arteriovenous fistula is an uncommon clinical entity. The right coronary artery is the most common site of origin, and the fistula commonly drains into the right-sided cardiac chambers. Very rarely it can arise from the left main coronary artery, and fistulas draining into the superior vena cavity are extremely rare. We report a 12-year-old asymptomatic boy with a large coronary arteriovenous fistula between the left main coronary artery and superior vena cava, with aneurysmal dilatation of the left main coronary artery. As the fistula was very large and to prevent its complications, it was planned to close the fistula percutaneously.

Abstract 742: Inducibility of Atrial Fibrillation in the Myocardial Sleeve of the Superior Vena Cava is Mediated by the Ganglionated Plexi on the Right Pulmonary Artery

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Guo-Dong Niu ◽  
Benjamin J Scherlag ◽  
Zhibing Lu ◽  
Muhammad Ghias ◽  
Ralph Lazzara ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Artery ◽  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Av Block ◽  
Ganglionated Plexi ◽  
Av Conduction ◽  
Right Pulmonary Artery ◽  
The Right

Introduction: Previous studies have shown that electrical stimulation of the ganglionated plexi (GP) on the right pulmonary artery (RPA), the so-called “3rd fat pad (FP)” causes slowing of the sinus rate and AV conduction. Ablation of this GP prevents induction of atrial fibrillation (AF) caused by vagosympathetic nerve (VNS) stimulation and atrial premature beats (APBs). Methods: Eleven dogs anesthetized with Na-pentobarbital were subjected to a right thoracotomy at the 4 th intercostal space. The RPA at the upper lobe of the right lung was dissected and the distal end tied in order to insert and stabilize an 8 Fr. Sheath into the RPA. A small basket electrode catheter, consisting of 5 splines, each spline containing 3 pairs of bipolar electrodes, was inserted into the RPA underneath the superior vena cava (SVC). A Lasso catheter, inserted through a sheath in the right jugular vein was positioned in the SVC contacting the sleeve of myocardium at the SVC-right atrial (RA) junction. Octapolar electrode catheters were sutured against the right superior, inferior pulmonary veins (PVs), RA and RA appendage. Through a left sided thoracotomy, similar placements of recording electrode catheters were made at the left superior, inferior PVs and left atrium (LA) body and appendage. Right and left vagosympathetic nerve stimulation (VNS, frequency, 20 Hz; stimulus duration, 0.01 ms; voltage 1.5– 4.5 Volts) slowed the heart rate (HR) by 50% or induced 2:1 AV block. The RPA GP was also stimulated to achieve similar effects on HR and AV block. Results: RPA GP stimulation consistently and significantly reduced the threshold for AF inducibility (control 8±3; RPA GP stimulation 3.2±1.5 volts, p<0.01) whereas after RPA GP ablation, the averaged voltage to induce AF was increased to 11.5±1.5 although 7 of 11 showed non-inducibility at the maximum voltage used (12 volts). The inducibility threshold at the other atrial and PV sites were unchanged by RPA GP stimulation before or after RPA GP ablation (p=NS). Moreover, there was a loss of HR slowing and AV block with VNS stimulation. Conclusion: RPA GP stimulation which markedly decreased HR or AV conduction selectively suppressed AF inducibility at the myocardial sleeve of the SVC but did not affect AF inducibility at other atrial sites.

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