Anatomical dilatation of the superior vena cava associated with an arrhythmogenic response induced by SVC scan pacing after atrial fibrillation ablation
| Autor: | Jun Kurose, Shumpei Mori, Koji Fukuzawa, Akinori Matsumoto, Akihiro Yoshida, Kiyohiro Hyogo, Tomofumi Takaya, Hirotoshi Ichibori, Hiroshi Imada, Kunihiko Kiuchi, Tatsuya Nishii, Hirata Ken-Ichi, Hiroki Konishi, Kiyosumi Kagawa |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
lcsh:Diseases of the circulatory (Cardiovascular) system AF atrial fibrillation medicine.medical_treatment Catheter ablation 030204 cardiovascular system & hematology SVC superior vena cava Pulmonary vein 03 medical and health sciences 0302 clinical medicine Superior vena cava Internal medicine Scan pacing Medicine 030212 general & internal medicine Atrial tachycardia PV pulmonary vein business.industry Atrial fibrillation Odds ratio Ablation medicine.disease CT computed tomography Catheter Arrhythmogenic response lcsh:RC666-701 Anesthesia Cardiology AT atrial tachycardia Original Article medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Arrhythmia, Vol 33, Iss 3, Pp 177-184 (2017) Journal of Arrhythmia |
| ISSN: | 1880-4276 |
| Popis: | Background The relationship between pulmonary vein (PV) arrhythmogenicity and its anatomy has been reported. However, that of the superior vena cava (SVC) has not been well discussed. Arrhythmogenic response induced by pacing stimulation at SVC might help with identifying SVC arrhythmogenicity. The purpose of this study was to investigate the relationship between the anatomical dilatation of SVC and the arrhythmogenic response induced by pacing at SVC. Methods Forty-three patients who underwent atrial fibrillation (AF) ablation were enrolled in this study. After PV isolation, scan pacing (up to triple extra stimulation following intrinsic sinus beats) was performed at SVC. The arrhythmogenic response was defined as following: (1) repetitive atrial responses, (2) non-sustained, and (3) sustained AF/ atrial tachycardia. To assess the dilatation of SVC, we measured the cross-sectional area of the SVC (SVC-area) using multi-planar reconstruction CT imaging. Results Arrhythmogenic responses were documented in 24 patients (Group 1). No arrhythmogenic responses were documented in the remaining 19 patients (Group 2). The SVC-area was significantly larger in Group 1 than Group 2 (3.1±0.9 vs. 2.2±0.8 cm 2 , P =0.004). A multivariate analysis revealed only SVC-area was associated with arrhythmogenic responses (odds ratio=2.87, CI 1.05–7.82, P =0.04). Furthermore, AF recurrence rate was significantly higher in patients with SVC-area>2.56 cm 2 than those with SVC-area 2 (9 [42.9%] of 21 vs. 3 [13.6%] of 22, P =0.026). Conclusion Dilatation of SVC was associated with an arrhythmogenic response, and the AF recurrence rate was significantly higher in patients with large SVC-area. Adjunctive catheter intervention for the SVC might be indicated in patients with a dilated SVC and an arrhythmogenic response. |
| Databáze: | OpenAIRE |
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