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Anatomical dilatation of the superior vena cava associated with an arrhythmogenic response induced by SVC scan pacing after atrial fibrillation ablation
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...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5459421/ https://www.ncbi.nlm.nih.gov/pubmed/28607612 http://dx.doi.org/10.1016/j.joa.2016.10.003 |
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author | Imada, Hiroshi Fukuzawa, Koji Kiuchi, Kunihiko Matsumoto, Akinori Konishi, Hiroki Ichibori, Hirotoshi Hyogo, Kiyohiro Kurose, Jun Mori, Shumpei Takaya, Tomofumi Nishii, Tatsuya Kagawa, Kiyosumi Yoshida, Akihiro Ken-ichi, Hirata |
author_facet | Imada, Hiroshi Fukuzawa, Koji Kiuchi, Kunihiko Matsumoto, Akinori Konishi, Hiroki Ichibori, Hirotoshi Hyogo, Kiyohiro Kurose, Jun Mori, Shumpei Takaya, Tomofumi Nishii, Tatsuya Kagawa, Kiyosumi Yoshida, Akihiro Ken-ichi, Hirata |
author_sort | Imada, Hiroshi |
collection | PubMed |
description | 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 <2.56 cm(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. |
format | Online Article Text |
id | pubmed-5459421 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-54594212017-06-12 Anatomical dilatation of the superior vena cava associated with an arrhythmogenic response induced by SVC scan pacing after atrial fibrillation ablation Imada, Hiroshi Fukuzawa, Koji Kiuchi, Kunihiko Matsumoto, Akinori Konishi, Hiroki Ichibori, Hirotoshi Hyogo, Kiyohiro Kurose, Jun Mori, Shumpei Takaya, Tomofumi Nishii, Tatsuya Kagawa, Kiyosumi Yoshida, Akihiro Ken-ichi, Hirata J Arrhythm Original Article 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 <2.56 cm(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. Elsevier 2017-06 2016-10-27 /pmc/articles/PMC5459421/ /pubmed/28607612 http://dx.doi.org/10.1016/j.joa.2016.10.003 Text en © 2016 Japanese Heart Rhythm Society. Published by Elsevier B.V. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Article Imada, Hiroshi Fukuzawa, Koji Kiuchi, Kunihiko Matsumoto, Akinori Konishi, Hiroki Ichibori, Hirotoshi Hyogo, Kiyohiro Kurose, Jun Mori, Shumpei Takaya, Tomofumi Nishii, Tatsuya Kagawa, Kiyosumi Yoshida, Akihiro Ken-ichi, Hirata Anatomical dilatation of the superior vena cava associated with an arrhythmogenic response induced by SVC scan pacing after atrial fibrillation ablation |
title | Anatomical dilatation of the superior vena cava associated with an arrhythmogenic response induced by SVC scan pacing after atrial fibrillation ablation |
title_full | Anatomical dilatation of the superior vena cava associated with an arrhythmogenic response induced by SVC scan pacing after atrial fibrillation ablation |
title_fullStr | Anatomical dilatation of the superior vena cava associated with an arrhythmogenic response induced by SVC scan pacing after atrial fibrillation ablation |
title_full_unstemmed | Anatomical dilatation of the superior vena cava associated with an arrhythmogenic response induced by SVC scan pacing after atrial fibrillation ablation |
title_short | Anatomical dilatation of the superior vena cava associated with an arrhythmogenic response induced by SVC scan pacing after atrial fibrillation ablation |
title_sort | anatomical dilatation of the superior vena cava associated with an arrhythmogenic response induced by svc scan pacing after atrial fibrillation ablation |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5459421/ https://www.ncbi.nlm.nih.gov/pubmed/28607612 http://dx.doi.org/10.1016/j.joa.2016.10.003 |
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