Document Detail


Sinus node injury as a result of superior vena cava isolation during catheter ablation for atrial fibrillation and atrial flutter.
MedLine Citation:
PMID:  20883509     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: The ectopic foci originating from superior vena cava (SVC) may act as triggers in the occurrence and perpetuation of atrial fibrillation (AF). Unfortunately, the SVC isolation may result in potential dysfunction of sinus node. Furthermore, little is known about the occurrence of sinus node injury complicated by the SVC isolation.
METHODS: Patients with AF or atypical atrial flutter experienced SVC isolation. The junctional rhythm or sinus arrest could be observed, if sinus node was injured. Atropin and dopamine administration ruled out the vagal irritation of sinus node, when junctional rhythm or sinus arrest occurred.
RESULTS: One hundred and thirty-two patients who had no electrocardiogram signs of sinus node dysfunction before ablation experienced the SVC isolation. Six patients (three men, three women, mean age 62.5 ± 8.6 years) had sinus node injury (4.5%, 6/132): four patients had junctional rhythm and one male patient had junctional rhythm and sinus arrest simultaneously; another male patient required AAI mode permanent pacemaker implantation due to the persistent junctional rhythm after SVC isolation. The ablation sites of all six patients closed to the junction of right atrium and SVC during the ablation of anterolateral free wall of the SVC.
CONCLUSION: Sinus node may be damaged due to the ablation sites closer to sinus node. The definition of the junction of right atrium and SVC is very important, the ablation sites of anterolateral free wall of the SVC should not be too close to the SVC orifice.
Authors:
Gang Chen; Jian Zeng Dong; Xing Peng Liu; Xin Yong Zhang; De Yong Long; Cai Hua Sang; Man Ning; Ri Bo Tang; Chen Xi Jiang; Chang Sheng Ma
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Publication Detail:
Type:  Journal Article     Date:  2010-09-30
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  34     ISSN:  1540-8159     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  163-70     Citation Subset:  IM    
Copyright Information:
©2010, The Authors. Journal compilation ©2010 Wiley Periodicals, Inc.
Affiliation:
Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing, China.
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