title: Atrial Fibrillation Ablation Without Pulmonary Vein Isolation in a Patient with Fontan Palliation.
abstract: In a patient with Fontan palliation and persistent atrial fibrillation two triggers were identified that initiated atrial fibrillation (AF) from the superior vena cava (SVC) and the right atrium. SVC triggers are more common in patients with a normal-sized left atrium. Eliminating these triggers prevented AF from being sustained in this patient and thus pulmonary vein isolation was not pursued. The patient has remained AF free for 3 years without medications or repeat ablation. Targeting of potential right-sided triggers for AF ablation, before pulmonary vein isolation, should be considered; such an approach may reduce risks in these complex patients.
authors.affiliation: Cardiac Electrophysiology, Cardiology Division, University of Colorado, Aurora, CO, USA.
authors.forename: Emily Sue
authors.initials: ES
authors.lastname: Ruckdeschel
authors.affiliation: Cardiac Electrophysiology, Cardiology Division, University of Colorado, Aurora, CO, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Kay
authors.affiliation: Cardiac Electrophysiology, Cardiology Division, University of Colorado, Aurora, CO, USA.
authors.forename: William H
authors.initials: WH
authors.lastname: Sauer
authors.affiliation: Cardiac Electrophysiology, Cardiology Division, University of Colorado, Aurora, CO, USA. Electronic address: duy.t.nguyen@ucdenver.edu.
authors.forename: Duy Thai
authors.initials: DT
authors.lastname: Nguyen
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation; D004562:Electrocardiography; D005260:Female; D018729:Fontan Procedure; D006801:Humans; D011667:Pulmonary Veins / Q000502:physiology*
keywords: Atrial fibrillation; Fontan palliation; Pulmonary vein isolation; Superior vena cava