Po-01-274 Persistent Atrial Fibrillation in Raghib Anomaly: Electrical Isolation of Left Superior Vena Cava Draining in the Left Atrium Using Pulsed Field Ablation

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Persistent atrial fibrillation and Raghib anomaly (n=1). Intervention: Pulsed field ablation. Primary outcome: Recurrence of atrial fibrillation.

Marinos Kosmopoulos; Babken Asatryan; Ari Cedars; Konstantinos N. Aronis

doi:10.1016/j.hrthm.2026.03.1814

April 1, 2026Heart RhythmOpen Access

Po-01-274 Persistent Atrial Fibrillation in Raghib Anomaly: Electrical Isolation of Left Superior Vena Cava Draining in the Left Atrium Using Pulsed Field Ablation

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Key result

PFA successfully isolates the LSVC and restores sinus rhythm in a Raghib anomaly case.

n=1

Key Points

To report the first successful electrical isolation of a left superior vena cava draining into the left atrium using pulsed field ablation in a patient with Raghib anomaly and persistent atrial fibrillation.
Evaluated a patient presenting with Raghib anomaly, a mitral valve anterior leaflet cleft, sick sinus syndrome, and recurrent persistent atrial fibrillation.
Conducted endocardial electroanatomic voltage mapping of both atria to evaluate electrical potentials across anomalous structures.
Applied pulsed field ablation using flower and basket configurations to isolate the four pulmonary veins, the left atrial posterior wall, and the left superior vena cava.
Voltage mapping revealed electrical activity on all four pulmonary veins and the left superior vena cava alongside extensive biatrial fibrosis.
Pulsed field ablation achieved entrance and exit block in all targeted veins and successfully terminated atrial fibrillation.
No recurrence of atrial fibrillation occurred during 6 weeks of clinical follow-up.

Study Design

Type

Case Report (n=1)

Structured PICO

P

Population

1 female patient with Raghib anomaly (left superior vena cava draining into the left atrium, absence of coronary sinus), valve anterior leaflet cleft, persistent atrial fibrillation, and sick sinus syndrome.

I

Intervention

Pulsed field ablation (isolation of pulmonary veins, posterior wall of the left atrium, and left superior vena cava)

O

Outcome

Successful isolation of left superior vena cava and termination of atrial fibrillation

Pulsed field ablation can safely and effectively isolate the left superior vena cava and restore sinus rhythm in patients with Raghib anomaly and persistent atrial fibrillation.

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Implication

May support pulsed field ablation feasibility for left superior vena cava isolation in Raghib anomaly; hypothesis-generating and requires prospective validation.

Abstract

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Discussion

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Cite This Study

Kosmopoulos et al. (2026) conducted a case report in Persistent atrial fibrillation and Raghib anomaly (n=1). Pulsed field ablation was evaluated on Recurrence of atrial fibrillation. Pulsed field ablation successfully isolated the left superior vena cava and restored sinus rhythm, with no recurrence of atrial fibrillation at 6 weeks in a patient with Raghib anomaly.

synapsesocial.com/papers/6a025e4893868c48f3093b08 https://doi.org/10.1016/j.hrthm.2026.03.1814

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Po-01-274 Persistent Atrial Fibrillation in Raghib Anomaly: Electrical Isolation of Left Superior Vena Cava Draining in the Left Atrium Using Pulsed Field Ablation

Key Points

Study Design

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Po-01-274 Persistent Atrial Fibrillation in Raghib Anomaly: Electrical Isolation of Left Superior Vena Cava Draining in the Left Atrium Using Pulsed Field Ablation

Key Points

Study Design

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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