Key result
RF ablation in a focal AF case suggests SVC activity drives AF initiation and maintenance.
Case Report (n=1)
This case demonstrates that focal AF in the superior vena cava can contribute to both the initiation and maintenance of atrial fibrillation, and can be successfully isolated using radiofrequency ablation.
May support SVC isolation for focal AF triggers; case report leaves open need for prospective validation before practice change.
We describe a case in which the superior vena cava (SVC) was electrically isolated by an application of radiofrequency energy to a point with electrical connection between the right atrium and the SVC in a patient with atrial fibrillation (AF) originating from the SVC. The connection was located in the posteroseptal region between the right atrium and the myocardial sleeve extending into the SVC. Local AF occurred after radiofrequency ablation and rapid activities were recorded all around the SVC, whereas the atrium was still in sinus rhythm. It is suggested that focal AF in the SVC contributes not only to the initiation but also to the maintenance of AF, and the myocardial sleeve extends into the SVC through a connection point to cover the entire internal lumen.
No takes yet. Share an insight, caveat, or question.
Ooie et al. (2002) conducted a case report in Atrial fibrillation originating from the superior vena cava (n=1). Radiofrequency ablation was evaluated on Electrical isolation of the superior vena cava and occurrence of local AF. Radiofrequency ablation successfully isolated the superior vena cava in a patient with focal atrial fibrillation, revealing that local AF in the SVC contributes to both initiation and maintenance of AF.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: