title: Long-term outcome of catheter ablation in patients with atrial fibrillation originating from the superior vena cava.
abstract: Long-Term Outcome of SVC AF Ablation.
  
  
  BACKGROUND
  Data of the long-term clinical outcome after superior vena cava (SVC) isolation are limited. We aimed to evaluate the long-term outcome in patients with atrial fibrillation (AF) who had triggers originating from the SVC and received catheter ablation of AF.
  
  
  RESULTS
  The study consisted of 68 patients (age 56 ± 12 years old, 32 males) who underwent the ablation procedure for drug-refractory, symptomatic paroxysmal AF originating from the SVC since 1999. Group 1 consisted of 37 patients with AF initiated from the SVC only, and group 2 consisted of 31 patients with both SVC and pulmonary vein (PV) triggers. During a follow-up period of 88 ± 50 months, the AF recurrence rate was 35.3% after a single procedure. The freedom-from-AF rates were 85.3% at 1 year and 73.3% at 5 years. In the baseline study, group 2 had larger left atrium (38 ± 4 mm vs 36 ± 5 mm, P = 0.04), left ventricle (50 ± 5 mm vs 46 ± 5 mm, P = 0.003), and PV diameters. Kaplan-Meier survival analysis showed a higher AF recurrence rate in group 2 compared to that in group 1 (P = 0.012). The independent predictor of an AF recurrence was a larger SVC diameter (P = 0.02, HR 1.4, 95% CI 1.1-1.8).
  
  
  CONCLUSIONS
  Among the patients with paroxysmal AF originating from the SVC, 73% remained free of AF for 5 years after a single catheter ablation procedure. Superior vena cava isolation without PV isolation is an acceptable therapeutic strategy in those patients with AF originating from the SVC only. The SVC diameter was an independent predictor of AF recurrence. (J Cardiovasc Electrophysiol, Vol. 23, pp. 955-961, September 2012).
authors.affiliation: Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Cardiology, Cheng Hsin General Hospital, Taipei, Taiwan.
authors.forename: Hung-Yu
authors.initials: HY
authors.lastname: Chang
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Lo
authors.forename: Yenn-Jiang
authors.initials: YJ
authors.lastname: Lin
authors.forename: Shih-Lin
authors.initials: SL
authors.lastname: Chang
authors.forename: Yu-Feng
authors.initials: YF
authors.lastname: Hu
authors.forename: An-Ning
authors.initials: AN
authors.lastname: Feng
authors.forename: Wei-Hsian
authors.initials: WH
authors.lastname: Yin
authors.forename: Cheng-Hung
authors.initials: CH
authors.lastname: Li
authors.forename: Tze-Fan
authors.initials: TF
authors.lastname: Chao
authors.forename: Beny
authors.initials: B
authors.lastname: Hartono
authors.forename: Fa-Po
authors.initials: FP
authors.lastname: Chung
authors.forename: Chen-Chuan
authors.initials: CC
authors.lastname: Cheng
authors.forename: Wei-Shiang
authors.initials: WS
authors.lastname: Lin
authors.forename: Hsuan-Ming
authors.initials: HM
authors.lastname: Tsao
authors.forename: Shih-Ann
authors.initials: SA
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000401:mortality / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016896:Treatment Outcome; D014683:Vena Cava, Superior / Q000601:surgery*