Noncontact mapping can effectively guide discrete radiofrequency ablation to achieve electrical disconnection of an arrhythmogenic superior vena cava.
Supports discrete SVC isolation in select AF cases; leaves open noncontact mapping utility without prospective validation.
This case describes a 54-year-old patient with paroxysmal atrial fibrillation and atrial flutter. Conventionally recorded local electrogram demonstrated a cycle length of 245 ms in the SVC which was conducted to the right atrium in a 2:1 fashion. The analysis of the virtual unipolar local electrogram from the noncontact mapping system demonstrated slow conduction between SVC and right atrium orthogonal to the atrial breakthrough in the upper part of the crista terminalis. RF ablation at the atrial breakthrough induced the electrical disconnection between the CVC and the right atrium.
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Weiß et al. (2003) studied this question.
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