Highlights the risk of sinus node injury as a complication of superior vena cava isolation when the sinus node origin is located inside the SVC.
Warrants caution in SVC isolation with high sinus node origin; case report leaves open optimal mapping strategies.
We report a case with SVC ectopy initiating AF; the origin and breakout point of the sinus node was inside the SVC, and the SVC ectopy was conducted through the same path as the sinus node activation to depolarize the right atrium. Injury to the sinus node happened after successful isolation of SVC.
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Ong et al. (2005) studied this question.
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