Provocation and Localization of Arrhythmogenic Triggers from Persistent Left Superior Vena Cava in Patients with Atrial Fibrillation
Background: Although pulmonary vein isolation (PVI) is an established procedure for atrial fibrillation (AF), non-PV foci play a crucial role in AF recurrence. Persistent left superior vena cava (PLSVC) has been reported as critical non-PV foci. However, the effectiveness of provocation of AF trigge...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
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MDPI AG
2023-02-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/5/1783 |
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| author | Kentaro Minami Kohki Nakamura Eiko Maeno Keitaro Iida Ikuta Saito Taiki Masuyama Yoshiyuki Kitagawa Toshiaki Nakajima Yosuke Nakatani Shigeto Naito Shigeru Toyoda Milan Chovanec Jan Petrů Jan Škoda Koji Kumagai Petr Neužil |
| author_facet | Kentaro Minami Kohki Nakamura Eiko Maeno Keitaro Iida Ikuta Saito Taiki Masuyama Yoshiyuki Kitagawa Toshiaki Nakajima Yosuke Nakatani Shigeto Naito Shigeru Toyoda Milan Chovanec Jan Petrů Jan Škoda Koji Kumagai Petr Neužil |
| author_sort | Kentaro Minami |
| collection | DOAJ |
| description | Background: Although pulmonary vein isolation (PVI) is an established procedure for atrial fibrillation (AF), non-PV foci play a crucial role in AF recurrence. Persistent left superior vena cava (PLSVC) has been reported as critical non-PV foci. However, the effectiveness of provocation of AF triggers from PLSVC remains unclear. This study was designed to validate the usefulness of provoking AF triggers from PLSVC. Methods: This multicenter retrospective study included 37 patients with AF and PLSVC. To provoke triggers, AF was cardioverted, and re-initiation of AF was monitored under high-dose isoproterenol infusion. The patients were divided into two groups: those whose PLSVC had arrhythmogenic triggers initiating AF (Group A) and those whose PLSVC did not have triggers (Group B). Group A underwent isolation of PLSVC after PVI. Group B received PVI only. Results: Group A had 14 patients, whereas Group B had 23 patients. After a 3-year follow-up, no difference in the success rate for maintaining sinus rhythm was observed between the two groups. Group A was significantly younger and had lower CHADS2-VASc scores than Group B. Conclusions: The provocation of arrhythmogenic triggers from PLSVC was effective for the ablation strategy. PLSVC electrical isolation would not be necessary if arrhythmogenic triggers are not provoked. |
| first_indexed | 2024-03-11T07:20:33Z |
| format | Article |
| id | doaj.art-5ee28772e7204cb39b2a77858e43c793 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T07:20:33Z |
| publishDate | 2023-02-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-5ee28772e7204cb39b2a77858e43c7932023-11-17T07:58:16ZengMDPI AGJournal of Clinical Medicine2077-03832023-02-01125178310.3390/jcm12051783Provocation and Localization of Arrhythmogenic Triggers from Persistent Left Superior Vena Cava in Patients with Atrial FibrillationKentaro Minami0Kohki Nakamura1Eiko Maeno2Keitaro Iida3Ikuta Saito4Taiki Masuyama5Yoshiyuki Kitagawa6Toshiaki Nakajima7Yosuke Nakatani8Shigeto Naito9Shigeru Toyoda10Milan Chovanec11Jan Petrů12Jan Škoda13Koji Kumagai14Petr Neužil15Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu 321-0293, Tochigi, JapanGunma Prefectural Cardiovascular Center, Maebashi 371-0004, Gunma, JapanDepartment of Cardiovascular Medicine, Dokkyo Medical University, Mibu 321-0293, Tochigi, JapanDepartment of Cardiovascular Medicine, Dokkyo Medical University, Mibu 321-0293, Tochigi, JapanDepartment of Cardiovascular Medicine, Dokkyo Medical University, Mibu 321-0293, Tochigi, JapanDepartment of Cardiovascular Medicine, Dokkyo Medical University, Mibu 321-0293, Tochigi, JapanDepartment of Cardiovascular Medicine, Dokkyo Medical University, Mibu 321-0293, Tochigi, JapanDepartment of Cardiovascular Medicine, Dokkyo Medical University, Mibu 321-0293, Tochigi, JapanGunma Prefectural Cardiovascular Center, Maebashi 371-0004, Gunma, JapanGunma Prefectural Cardiovascular Center, Maebashi 371-0004, Gunma, JapanDepartment of Cardiovascular Medicine, Dokkyo Medical University, Mibu 321-0293, Tochigi, JapanDepartment of Cardiology, Na Homolce Hospital, 15030 Prague, Czech RepublicDepartment of Cardiology, Na Homolce Hospital, 15030 Prague, Czech RepublicDepartment of Cardiology, Na Homolce Hospital, 15030 Prague, Czech RepublicDepartment of Cardiovascular Medicine, Tohoku Medical and Pharmaceutical University, Sendai 983-8536, Miyagi, JapanDepartment of Cardiology, Na Homolce Hospital, 15030 Prague, Czech RepublicBackground: Although pulmonary vein isolation (PVI) is an established procedure for atrial fibrillation (AF), non-PV foci play a crucial role in AF recurrence. Persistent left superior vena cava (PLSVC) has been reported as critical non-PV foci. However, the effectiveness of provocation of AF triggers from PLSVC remains unclear. This study was designed to validate the usefulness of provoking AF triggers from PLSVC. Methods: This multicenter retrospective study included 37 patients with AF and PLSVC. To provoke triggers, AF was cardioverted, and re-initiation of AF was monitored under high-dose isoproterenol infusion. The patients were divided into two groups: those whose PLSVC had arrhythmogenic triggers initiating AF (Group A) and those whose PLSVC did not have triggers (Group B). Group A underwent isolation of PLSVC after PVI. Group B received PVI only. Results: Group A had 14 patients, whereas Group B had 23 patients. After a 3-year follow-up, no difference in the success rate for maintaining sinus rhythm was observed between the two groups. Group A was significantly younger and had lower CHADS2-VASc scores than Group B. Conclusions: The provocation of arrhythmogenic triggers from PLSVC was effective for the ablation strategy. PLSVC electrical isolation would not be necessary if arrhythmogenic triggers are not provoked.https://www.mdpi.com/2077-0383/12/5/1783persistent left superior vena cavaatrial fibrillationcatheter ablation |
| spellingShingle | Kentaro Minami Kohki Nakamura Eiko Maeno Keitaro Iida Ikuta Saito Taiki Masuyama Yoshiyuki Kitagawa Toshiaki Nakajima Yosuke Nakatani Shigeto Naito Shigeru Toyoda Milan Chovanec Jan Petrů Jan Škoda Koji Kumagai Petr Neužil Provocation and Localization of Arrhythmogenic Triggers from Persistent Left Superior Vena Cava in Patients with Atrial Fibrillation Journal of Clinical Medicine persistent left superior vena cava atrial fibrillation catheter ablation |
| title | Provocation and Localization of Arrhythmogenic Triggers from Persistent Left Superior Vena Cava in Patients with Atrial Fibrillation |
| title_full | Provocation and Localization of Arrhythmogenic Triggers from Persistent Left Superior Vena Cava in Patients with Atrial Fibrillation |
| title_fullStr | Provocation and Localization of Arrhythmogenic Triggers from Persistent Left Superior Vena Cava in Patients with Atrial Fibrillation |
| title_full_unstemmed | Provocation and Localization of Arrhythmogenic Triggers from Persistent Left Superior Vena Cava in Patients with Atrial Fibrillation |
| title_short | Provocation and Localization of Arrhythmogenic Triggers from Persistent Left Superior Vena Cava in Patients with Atrial Fibrillation |
| title_sort | provocation and localization of arrhythmogenic triggers from persistent left superior vena cava in patients with atrial fibrillation |
| topic | persistent left superior vena cava atrial fibrillation catheter ablation |
| url | https://www.mdpi.com/2077-0383/12/5/1783 |
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