Why the study?
Paroxysmal atrial fibrillation can be triggered by non-pulmonary vein foci, such as the superior vena cava.
Superior vena cava isolation can be accomplished by ablating specific connection points to the right atrium rather than requiring a full circular ablation.
May support superior vena cava isolation in select refractory atrial fibrillation; hypothesis-generating and requires prospective validation.
Background: Paroxysmal atrial fibrillation can be triggered by non-pulmonary vein foci, such as the superior vena cava. Here, we report the case of a patient with a 6-year history of paroxysmal atrial fibrillation who received cryoballoon ablation in 2012 but relapsed in 2014. He then received cardiac radiofrequency ablation, which successfully isolated the left pulmonary vein and superior vena cava, but the arrhythmia recently relapsed again. The tachycardia was finally successfully terminated by ablation on the free wall without recurrence during a 2-year following up. Conclusion: Superior vena cava isolation may not require ablation isolation with a full circle way and can be accomplished by ablating several connection points between the superior vena cava and the right atrium.
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Yin et al. (2022) studied this question.
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