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Higuchi K, Yamauchi Y, Hirao K. Superior Vena Cava Isolation In Ablation Of Atrial Fibrillation. J Atr Fibrillation. 2014;7(1):1032doi: 10.4022/jafib.1032.
Higuchi, K., Yamauchi, Y., & Hirao, K. (2014). Superior Vena Cava Isolation In Ablation Of Atrial Fibrillation. Journal of atrial fibrillation, 7(1), 1032. https://doi.org/10.4022/jafib.1032
Higuchi, Koji, et al. "Superior Vena Cava Isolation In Ablation Of Atrial Fibrillation." Journal of atrial fibrillation vol. 7,1 (2014): 1032. doi: https://doi.org/10.4022/jafib.1032
Higuchi K, Yamauchi Y, Hirao K. Superior Vena Cava Isolation In Ablation Of Atrial Fibrillation. J Atr Fibrillation. 2014 Jun 30;7(1):1032. doi: 10.4022/jafib.1032. eCollection 2014. PMID: 27957077; PMCID: PMC5135146.
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J Atr Fibrillation. 2014 Jun 30;7(1):1032. doi: 10.4022/jafib.1032. eCollection 2014.

Superior Vena Cava Isolation In Ablation Of Atrial Fibrillation.

Journal of atrial fibrillation

Koji Higuchi, Yasuteru Yamauchi, Kenzo Hirao

Affiliations

  1. Hiratsuka Kyosai Hospital, Kanagawa, Japan.
  2. Musashino Red Cross Hospital, Tokyo, Japan.
  3. Tokyo Medical and Dental University, Tokyo, Japan.

PMID: 27957077 PMCID: PMC5135146 DOI: 10.4022/jafib.1032

Abstract

Superior vena cava (SVC) is one of the most important non-pulmonary vein (PV) origins of atrial fibrillation (AF). SVC isolation (SVCI) is effective especially in patients with paroxysmal AF from SVC origin. However, SVCI should be carefully performed because of potential complications such as phrenic nerve paralysis, SVC stenosis, and sinus node injury There are two major different approaches to treat SVC focus in the ablation of AF. The conventional approach is to perform SVCI only if AF from the SVC origin is actually recognized using pacing maneuvers and/or isoproterenol infusions. Another approach is the empiric empiricprophylactic SVCI in addition to PV isolation in all cases. The rate of AF freedom one year after initial AF ablation by empiric SVCI was almost same as the conventional method (85-90% AF freedom). Additionally, the conventional method has also a good result even 5 years after ablation (,73.3% AF freedom). Because of the excellent result in the conventional approach and possible complications after the SVCI, the empiric SVCI + PVI in all AF cases is still controversial. Patients with a long SVC myocardial sleeve are possible candidates for empiric SVCI in addition to PVI.

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