title: Catheter ablation of atrial fibrillation originating from superior vena cava.
abstract: Atrial fibrillation originating from rapid firing foci in the superior vena cava is rare. Its electrophysiological features and catheter ablation techniques are described in this report. A decapolar catheter was positioned in the superior vena cava to map the origin of the atrial fibrillation in a 39-year-old female patient who had a 3-year history of symptomatic atrial tachycardia and fibrillation. Intracardiac mapping showed rapid firing foci in the anterior wall of the superior vena cava (SVC), 2.0 cm above the SVC-right atrium junction. During tachycardia, the focal electrogram from SVC was 55 msec earlier than the P waves on body surface ECG. Radiofrequency catheter ablation successfully abolished SVC potentials, resulting in a SVC-atrium conduction block. There was no recurrence of atrial arrhythmia after a 14-month follow-up. Rapid activities from the muscle sleeves in the SVC may cause atrial fibrillation. Such a focal atrial fibrillation can be eliminated by isolating the arrhythmogenic SVC with radiofrequency catheter ablation.
authors.affiliation: Department of Cardiology, The Affiliated Hospital of Weifang Medical College, Shandong Province, the People's Republic of China.
authors.forename: Jingtian
authors.initials: J
authors.lastname: Li
authors.forename: Lexin
authors.initials: L
authors.lastname: Wang
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000473:pathology*; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007545:Isoproterenol / Q000008:administration & dosage / Q000494:pharmacology; D014683:Vena Cava, Superior / Q000187:drug effects / Q000473:pathology*
chemical_list: D007545:Isoproterenol