Electrical isolation of the superior vena cava can be an effective treatment for atrial tachycardia originating from this structure when focal ablation is not feasible.
May be considered for SVC-origin atrial tachycardia refractory to focal ablation; leaves open need for prospective validation of efficacy and patency.
GERSTENFELD, E.P., et al .: Atrial Tachycardia Successfully Treated by Electrical Isolation of the Superior Vena Cava. This case report describes a patient with an atrial tachycardia that was difficult to induce and that originated from the superior vena cava. Although the patient had frequent episodes of tachycardia, the tachycardia induced in the electrophysiological laboratory was nonsustained and could not be adequately localized for focal ablation. A circumferential mapping catheter was used to guide electrical isolation of the superior vena cava from the right atrium, curing the tachycardia. Electroanatomic mapping and intracardiac echocardiography were used to monitor the ablation and document patency of the superior vena cava throughout the ablation. (PACE 2003; 26[Pt. I]:906–910)
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Gerstenfeld et al. (2003) studied this question.
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