Complete free wall isolation of arrhythmogenic persistent left superior vena cava

J Cardiovasc Electrophysiol. 2024 Apr;35(4):862-866. doi: 10.1111/jce.16207. Epub 2024 Feb 7.

Abstract

Introduction: Persistent left superior vena cava (PLSVC) is one of the major sources of triggers and drivers of atrial fibrillation (AF). There has been no established PLSVC ablation procedure to eliminate the arrhythmogenicity along the entire length of PLSVC.

Methods and results: A 70-year-old woman with a history of two previous catheter ablations for AF, mitral valvuloplasty, and an unroofed coronary sinus-type atrial septal defect closure underwent the redo AF ablations. The AF trigger and driver were identified within the patient's enlarged PLSVC. The AF was treated by complete PLSVC free wall isolation.

Conclusion: Complete PLSVC free wall isolation may be an effective ablation method to eliminate the arrhythmogenicity along the entire length of the PLSVC.

Keywords: atrial fibrillation; catheter ablation; persistent left superior vena cava; ultrahigh‐resolution mapping system.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Atrial Fibrillation* / diagnosis
  • Atrial Fibrillation* / surgery
  • Cardiac Surgical Procedures*
  • Female
  • Heart Septal Defects, Atrial* / surgery
  • Humans
  • Persistent Left Superior Vena Cava*
  • Vena Cava, Superior / diagnostic imaging
  • Vena Cava, Superior / surgery