Long-Term Follow-Up Result of Catheter Ablation in Atrial Fibrillation Initiating from Superior Vena Cava

Objectives: The long-term outcome after superior vena cava (SVC) isolation for SVC-initiating atrial fibrillation (AF) is limited. Methods: The study consisted of 69 consecutive patients (age 55±13 y/o, 33 males) who had undergone SVC isolation during AF ablation since 1999. Group 1 consisted of 34 patients with AF initiating from the SVC only, and group 2 consisted of 35 patients with both SVC and pulmonary vein triggers. Results: During a follow-up period of 81±53 months, the AF recurrence rate was 36.2%. Univariate study showed that group 1 had a higher incidence of concomitant atrioventricular nodal reentrant tachycardia, whereas group 2 had a higher incidence of hypertension, larger left atrial and left ventricular diameters, larger PVs diameters. Kaplan-Meier survival analysis showed a higher AF recurrent rate in group 2 compared to that in group 1 (p=0.041). In multivariate analysis, the independent predictors for the AF recurrence was a larger SVC diameter. Conclusions: Among patients with AF originating from the SVC, the AF freedom rate was 63.8% during the long-term follow-up after Catheter ablation. Patients with AF initiating from both the SVC and pulmonary veins had a higher incidence of AF recurrence than those with SVC triggers only. Larger SVC diameter could predict the recurrence of AF.