Novel concept of atrial tachyarrhythmias originating from the superior vena cava: insight from noncontact mapping.
BACKGROUND
Information about the activation patterns inside the superior vena cava (SVC) and entry and exit sites at the SVC-right atrial (RA) junction during SVC tachyarrhythmia is limited.


RESULTS
A detailed characterization of electrophysiologic mechanisms and ablation strategies was performed using a noncontact three-dimensional mapping system in two cases of SVC tachycardia. The first case demonstrated SVC tachycardia originating from an ectopic focus inside the SVC, with sustained depolarization and conduction to the atrium. Entry and exit sites across the SVC-RA junction were located very close to each other. The second case demonstrated two different reentrant circuits, one inside the SVC and the other into and out of the SVC-RA junction. The entry and exit sites were located far away from each other.


CONCLUSIONS
Noncontact mapping may help to reveal the mechanism of SVC tachyarrhythmias and to locate entry and exit sites at the SVC-RA junction as a guide for catheter ablation.
Liu
Tu-Ying
TY
Division of Cardiology, Department of Medicine, National Yang-Ming University, School of Medicine, and Taipei Veterans General Hospital, Taiwan, Republic of China.
Tai
Ching-Tai
CT
Lee
Pi-Chang
PC
Hsieh
Ming-Hsiung
MH
Higa
Satoshi
S
Ding
Yu-An
YA
Chen
Shih-Ann
SA
D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D018780:Body Surface Potential Mapping; D017115:Catheter Ablation; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D013612:Tachycardia, Ectopic Atrial / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014683:Vena Cava, Superior / Q000473:pathology* / Q000601:surgery