Ectopies from the superior vena cava after pulmonary vein isolation in patients with atrial fibrillation

2015 ◽  
Vol 31 (9) ◽  
pp. 1562-1569 ◽  
Author(s):  
Sousuke Sugimura ◽  
Takashi Kurita ◽  
Kazuaki Kaitani ◽  
Ryobun Yasuoka ◽  
Shunichi Miyazaki
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Superior Vena Cava ◽  
Pulmonary Vein Isolation ◽  
Superior Vena ◽  
Vena Cava

scholarly journals Relationship between effective refractory period and inducibility of atrial fibrillation from the superior vena cava after pulmonary vein isolation

2021 ◽  
Author(s):  
Yasunobu Yamagishi ◽  
Yasushi Oginosawa ◽  
Yoshihisa Fujino ◽  
Keishiro Yagyu ◽  
Taro Miyamoto ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Superior Vena Cava ◽  
Pulmonary Vein Isolation ◽  
Refractory Period ◽  
Superior Vena ◽  
Three Dimensional ◽  
Vena Cava ◽  
Effective Refractory Period ◽  
Electrical Stimuli

Background: In terms of the pulmonary vein (PV), atrial fibrillation (AF) patients have a shorter effective refractory period (ERP) and a larger dispersion of the ERP than patients without AF. Although the frequency of AF from the superior vena cava (SVC) was the highest among non-PV foci, the characteristics of the ERP in the SVC (SVC-ERP) were unclear. The purpose of this study was to elucidate the relationship between SVC-ERP and the inducibility of AF after pulmonary vein isolation (PVI). Methods and Results: Consecutive 28 patients who underwent PVI were included. After successful PVI, the SVC-ERP was measured at three positions in SVC. Rapid electrical stimuli were delivered at the shortest SVC-ERP to induce AF. Patients in whom AF was induced were assigned to the SVC-induced group (SIG) and the remaining patients were the non-SVC-induced group (non-SIG). The size of the SVC sleeve was evaluated using three-dimensional electroanatomic mapping. The SIG had a significantly shorter average SVC-ERP (236.0±25.2 vs. 294.8±36.8 ms, p<0.001), while SVC-ERP dispersion was not significantly different (30.0±25.4 vs. 33.3±20.1 ms, p=0.56). Although the longer SVC diameter was significantly longer in the SIG (27.4±4.3 vs. 22.9±4.6 mm, p=0.03), the SVC-ERP was significantly associated with pacing inducibility of AF after adjustment for the longer SVC diameter (odds ratio: 0.96 [1-ms increments], p=0.01). Conclusions: The SIG had a shorter SVC-ERP, while the dispersion was not significantly different between the two groups. The SVC-ERP can be one of the mechanisms of arrhythmogenicity for AF originating from the SVC.

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