Key result
Catheter ablation yields up to ~100% immediate success in patients with PLSVC and left accessory pathways.
Why the study?
Persistent left superior vena cava (PLSVC) is a rare site for accessory pathways, and the role of navigation systems in catheter ablation within PLSVC is not well established.
Systematic Review (n=71)
May support CS or transseptal ablation in PLSVC with left APs; leaves open durability, recurrence, and optimal strategy in larger series.
We report the ablation procedure of a concealed accessory pathway (AP) localized within a persistent left superior vena cava (PLSVC) in which the use of the LocaLisa system was of great value. The AP was the source of symptomatic AV re-entrant tachycardia and located in the initial portion of a PLSVC. The LocaLisa system allowed correct catheter placement and monitoring of stability. Five cooled-radiofrequency applications within the PLSVC suppressed the AP. PLSVC is a very unusual site of APs. The use of a navigation system may be extremely helpful in improving catheter ablation placement and stability in a very dilated vessel.
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Bortone et al. (2006) conducted a systematic review in Persistent left superior vena cava (PLSVC) combined with left accessory pathways (n=71). Catheter ablation was evaluated on Immediate success rate of ablation. In a systematic review of 71 patients with persistent left superior vena cava and left accessory pathways, catheter ablation achieved immediate success rates of 100% via the coronary sinus and 91.7% via the atrial septum.
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