1. Provocation and Localization of Arrhythmogenic Triggers from Persistent Left Superior Vena Cava in Patients with Atrial Fibrillation.
- Author
-
Minami, Kentaro, Nakamura, Kohki, Maeno, Eiko, Iida, Keitaro, Saito, Ikuta, Masuyama, Taiki, Kitagawa, Yoshiyuki, Nakajima, Toshiaki, Nakatani, Yosuke, Naito, Shigeto, Toyoda, Shigeru, Chovanec, Milan, Petrů, Jan, Škoda, Jan, Kumagai, Koji, and Neužil, Petr
- Subjects
VENA cava superior ,ATRIAL fibrillation ,PROVOCATION tests (Medicine) ,PULMONARY veins ,GALVANIC isolation - Abstract
Background: Although pulmonary vein isolation (PVI) is an established procedure for atrial fibrillation (AF), non-PV foci play a crucial role in AF recurrence. Persistent left superior vena cava (PLSVC) has been reported as critical non-PV foci. However, the effectiveness of provocation of AF triggers from PLSVC remains unclear. This study was designed to validate the usefulness of provoking AF triggers from PLSVC. Methods: This multicenter retrospective study included 37 patients with AF and PLSVC. To provoke triggers, AF was cardioverted, and re-initiation of AF was monitored under high-dose isoproterenol infusion. The patients were divided into two groups: those whose PLSVC had arrhythmogenic triggers initiating AF (Group A) and those whose PLSVC did not have triggers (Group B). Group A underwent isolation of PLSVC after PVI. Group B received PVI only. Results: Group A had 14 patients, whereas Group B had 23 patients. After a 3-year follow-up, no difference in the success rate for maintaining sinus rhythm was observed between the two groups. Group A was significantly younger and had lower CHADS2-VASc scores than Group B. Conclusions: The provocation of arrhythmogenic triggers from PLSVC was effective for the ablation strategy. PLSVC electrical isolation would not be necessary if arrhythmogenic triggers are not provoked. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF