Key result
Modified SVC isolation with ultra-high-resolution mapping safely isolates ectopic origins in a recurrent AF patient.
Case Report (n=1)
Ultra-high-resolution mapping can guide successful and safe modified superior vena cava isolation in patients with AF triggers near the sinus node.
SVC isolation near sinus node feasible in recurrent AF; leaves open role of ultra-high-resolution mapping in routine practice.
We report a case of atrial fibrillation (AF) recurrence after pulmonary vein isolation, which patient had AF trigger in the superior vena cava (SVC) near the sinus node (SN). The ultra-high-resolution mapping revealed that SN located within the SVC and the atrial activation from the SN to SVC propagated in both septal and lateral direction, then upward with circumventing the spontaneous conduction block identified just above and lateral SN (upper hemisphere). We successfully isolated SVC including the ectopic origin at the same level as the SN by utilizing the spontaneous conduction block line around the SN without any complication.
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Yamashita et al. (2023) conducted a case report in Atrial fibrillation recurrence after pulmonary vein isolation (n=1). Modified superior vena cava isolation using ultra-high-resolution mapping system was evaluated on Successful isolation of SVC without complication. Modified superior vena cava isolation using an ultra-high-resolution mapping system successfully isolated the SVC including the ectopic origin without any complications in a patient with AF recurrence.
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