Long-term outcome of catheter ablation in patients with atrial fibrillation originating from the superior vena cava

Hung Yu Chang, Li Wei Lo, Yenn Jiang Lin, Shih Lin Chang, Yu Feng Hu, An Ning Feng, Wei Hsian Yin, Cheng Hung Li, Tze Fan Chao, Beny Hartono, Fa Po Chung, Chen Chuan Cheng, Wei Shiang Lin, Hsuan Ming Tsao*, Shih Ann Chen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

42 Scopus citations

Abstract

Introduction: 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. Methods and 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). Conclusion: 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.

Original languageEnglish
Pages (from-to)955-961
Number of pages7
JournalJournal of cardiovascular electrophysiology
Volume23
Issue number9
DOIs
StatePublished - Sep 2012

Keywords

  • Atrial fibrillation
  • Catheter ablation
  • Pulmonary vein isolation
  • Superior vena cava

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