Persistent left superior vena cava as an arrhythmogenic source in atrial fibrillation: results from a multicenter experience.

Autor: Turagam MK; Icahn School of Medicine at Mount Sinai, New York, NY, USA., Atoui M; St. Cloud Hospital, St. Cloud, MN, USA., Atkins D; Kansas City Heart Rhythm Institute & Research Foundation, Overland Park Regional Medical Center, HCA MidWest, Kansas City, KS, 66221, USA., Di Biase L; Montefiore Medical Center, Bronx, NY, USA., Shivkumar K; UCLA Medical Center, Los Angeles, CA, USA., Jared Bunch T; Intermountain Medical Center, Murray, UT, USA., Mohanty S; Texas Cardiac Arrhythmia Center, Austin, TX, USA., Gianni C; Texas Cardiac Arrhythmia Center, Austin, TX, USA., Natale A; Texas Cardiac Arrhythmia Center, Austin, TX, USA., Lakkireddy D; Kansas City Heart Rhythm Institute & Research Foundation, Overland Park Regional Medical Center, HCA MidWest, Kansas City, KS, 66221, USA. dhanunjaya.lakkireddy@hcahealthcare.com.; Kansas City Heart Rhythm Institute and Research Foundation, Kansas City, KS, 66221, USA. dhanunjaya.lakkireddy@hcahealthcare.com.
Jazyk: angličtina
Zdroj: Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing [J Interv Card Electrophysiol] 2019 Mar; Vol. 54 (2), pp. 93-100. Date of Electronic Publication: 2018 Sep 27.
DOI: 10.1007/s10840-018-0444-x
Abstrakt: Background: Persistent left superior vena cava (PLSVC) is one of the most frequently reported congenital anomalies and may be an important source of trigger of atrial fibrillation (AF).
Methods: This was a multicenter retrospective experience including 28 patients with PLSVC who were referred for catheter ablation for drug-refractory symptomatic AF. Pulmonary vein and PLSVC isolation were performed (3.5-mm open irrigated tip ablation catheter at maximum power of 20 W, maximum temperature 43 °C with flow rate of 17 ml/min). Clinical outcomes such as complications and long-term freedom from AF were measured.
Results: The mean age of the population was 61 ± 8 years, 21% were females, and AF duration was 60 ± 33 months. Sixty-one percent paroxysmal AF (17/28), 25% (7/28) persistent AF, and 14% (4/28) had long-standing persistent AF. There were no major complications that required any intervention. PLSVC isolation was achieved in 96% (27/28). Freedom from AF at 1 year without antiarrhythmic drugs was seen in 75% (21/28) of patients.
Conclusions: In PLSVC patients with AF, segmental isolation of PLSVC appears to be feasible and safe and can translate into favorable clinical outcomes.
Databáze: MEDLINE
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