Document Detail

Left superior vena cava conduction to the left atrium unmasked by adenosine in a patient with paroxysmal atrial fibrillation during pulmonary vein isolation.
MedLine Citation:
PMID:  19880849     Owner:  NLM     Status:  MEDLINE    
The use of adenosine in unmasking potential 'trigger' activity in a patient with paroxysmal atrial fibrillation (AF) and persistent left superior vena cava (LSVC) has never been reported. In a 75-year-old woman with paroxysmal AF and LSVC anomaly, pulmonary vein isolation (PVI) procedure was performed. After successful PVI, repeated bolus adenosine infusions were given. Adenosine response originating from the LSVC was observed: it was reproducible, brief, and exhibited decremental atrial-to-LSVC conduction properties until cessation. Pacing from the LSVC resulted in atrial capture (confirming vein-to-atrium conduction). Disconnection of the LSVC from the coronary sinus (CS) was obtained by successfully ablating within the distal CS. Adenosine challenge may be important to identify AF triggers in non-PVI foci.
Fran?ois Regoli; Santi Raffa; Anett Grosse; Michele Brunelli; J Christoph Geller
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  12     ISSN:  1532-2092     ISO Abbreviation:  Europace     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-16     Completed Date:  2010-02-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  130-2     Citation Subset:  IM    
Division of Cardiology, Arrhythmia and Electrophysiology Section, Zentralklinik Bad Berka, Germany.
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MeSH Terms
Adenosine / diagnostic use*
Atrial Fibrillation / diagnosis*,  etiology,  surgery*
Diagnosis, Differential
Electrocardiography / drug effects*
Heart Atria / abnormalities*,  drug effects
Heart Conduction System / abnormalities*,  drug effects
Pulmonary Veins / surgery*
Vasodilator Agents / diagnostic use
Vena Cava, Superior / abnormalities*,  drug effects
Reg. No./Substance:
0/Vasodilator Agents; 58-61-7/Adenosine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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