Electrical Isolation of Superior Vena Cava Besides Pulmonary Vein Isolation by Cryoballoon Technique in a Young Patient with Persistent Atrial Fibrillation

2016 ◽  
Author(s):  
Ugur Canpolat
Keyword(s):  
Atrial Fibrillation ◽  
Young Patient ◽  
Pulmonary Vein ◽  
Superior Vena Cava ◽  
Pulmonary Vein Isolation ◽  
Superior Vena ◽  
Vena Cava ◽  
Persistent Atrial Fibrillation ◽  
Electrical Isolation

Ectopies from the superior vena cava after pulmonary vein isolation in patients with atrial fibrillation

2015 ◽  
Vol 31 (9) ◽  
pp. 1562-1569 ◽  
Author(s):  
Sousuke Sugimura ◽  
Takashi Kurita ◽  
Kazuaki Kaitani ◽  
Ryobun Yasuoka ◽  
Shunichi Miyazaki
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Superior Vena Cava ◽  
Pulmonary Vein Isolation ◽  
Superior Vena ◽  
Vena Cava

scholarly journals Long-Standing Persistent Atrial Fibrillation Ablation: How Do You Perform? Left and Right Atrial Linear Ablation in Addition to Pulmonary Vein Isolation

2020 ◽  
Vol 33 (2) ◽  
pp. 106-114
Author(s):  
Michele Brunelli ◽  
Mark Adrian Sammut
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Low Voltage ◽  
Superior Vena ◽  
Pulmonary Veins ◽  
Vena Cava ◽  
Persistent Atrial Fibrillation ◽  
Right Atrial ◽  
Linear Ablation

Catheter ablation of long-standing persistent atrial fibrillation is not yet clearly defined with respect to endpoints, and different ablative strategies are offered to patients. Presented here is an approach aiming at biatrial debulking in the form of extensive linear ablation, specifically targeting areas of low-voltage complex fractionated electrograms, in addition to pulmonary vein isolation. Its main advantage is that it is not dependent on operator/system variability, since the strategy of isolating the pulmonary veins, superior vena cava and left atrial posterior wall together with achievement of bidirectional block during linear ablation provides objective endpoints that can consistently be reproduced.

scholarly journals The effect of empirical superior vena cava isolation during total thoracoscopic ablation in patients with persistent atrial fibrillation

2021 ◽  
Author(s):  
Hee-jin Kwon ◽  
Dong Seop Jeong ◽  
Hye Ree Kim ◽  
Seung-Jung Park ◽  
Kyoung-Min Park ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Survival Rate ◽  
Pulmonary Vein ◽  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Persistent Atrial Fibrillation ◽  
Surgical Ablation ◽  
Free Survival ◽  
Improve Patient

Introduction: In patients with non-paroxysmal AF, various ablation strategies have been attempted to target non-pulmonary vein (PV) foci or to achieve substrate modification beyond pulmonary vein isolation (PVI). The efficacy of empirical ablation of the SVC, one of the most common non-PV foci, is unclear. The aim of this study was to investigate the efficacy and safety of additional superior vena cava (SVC) isolation in patients with non-paroxysmal atrial fibrillation (AF) undergoing thoracoscopic surgical ablation. Methods and Results: A total of 191 patients with persistent or longstanding persistent AF was enrolled. All patients underwent total thoracoscopic surgical ablation for AF, and half of them also received empirical SVC isolation. We compared the atrial-tachyarrhythmia (ATa)-free survival rate and procedure-related complications in the two groups of patients. The 3-year ATa-free survival rate was 53% in the SVC-isolation group and 52% in the no-SVC-isolation group, (p = 0.644). There were no differences between the two groups with respect to AF type or LA size. Procedure-related complications occurred in 12 patients (6%). Pacemakers were implanted only in 3 patients from the SVC-isolation group. The only factor influencing recurrence of ATa was LA diameter. Conclusions: Empirical SVC isolation during thoracoscopic ablation for persistent AF did not improve patient outcomes.

scholarly journals Relationship between effective refractory period and inducibility of atrial fibrillation from the superior vena cava after pulmonary vein isolation

2021 ◽  
Author(s):  
Yasunobu Yamagishi ◽  
Yasushi Oginosawa ◽  
Yoshihisa Fujino ◽  
Keishiro Yagyu ◽  
Taro Miyamoto ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Superior Vena Cava ◽  
Pulmonary Vein Isolation ◽  
Refractory Period ◽  
Superior Vena ◽  
Three Dimensional ◽  
Vena Cava ◽  
Effective Refractory Period ◽  
Electrical Stimuli

Background: In terms of the pulmonary vein (PV), atrial fibrillation (AF) patients have a shorter effective refractory period (ERP) and a larger dispersion of the ERP than patients without AF. Although the frequency of AF from the superior vena cava (SVC) was the highest among non-PV foci, the characteristics of the ERP in the SVC (SVC-ERP) were unclear. The purpose of this study was to elucidate the relationship between SVC-ERP and the inducibility of AF after pulmonary vein isolation (PVI). Methods and Results: Consecutive 28 patients who underwent PVI were included. After successful PVI, the SVC-ERP was measured at three positions in SVC. Rapid electrical stimuli were delivered at the shortest SVC-ERP to induce AF. Patients in whom AF was induced were assigned to the SVC-induced group (SIG) and the remaining patients were the non-SVC-induced group (non-SIG). The size of the SVC sleeve was evaluated using three-dimensional electroanatomic mapping. The SIG had a significantly shorter average SVC-ERP (236.0±25.2 vs. 294.8±36.8 ms, p<0.001), while SVC-ERP dispersion was not significantly different (30.0±25.4 vs. 33.3±20.1 ms, p=0.56). Although the longer SVC diameter was significantly longer in the SIG (27.4±4.3 vs. 22.9±4.6 mm, p=0.03), the SVC-ERP was significantly associated with pacing inducibility of AF after adjustment for the longer SVC diameter (odds ratio: 0.96 [1-ms increments], p=0.01). Conclusions: The SIG had a shorter SVC-ERP, while the dispersion was not significantly different between the two groups. The SVC-ERP can be one of the mechanisms of arrhythmogenicity for AF originating from the SVC.

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