Life Science and Bioethics Research Center, Tokyo Medical and Dental University.
Cardiovascular Division, Saitama Red Cross Hospital.
Circ J. 2017 Dec 25;82(1):71-77. doi: 10.1253/circj.CJ-17-0350. Epub 2017 Aug 11.
Atrial fibrillation (AF) can be initiated from arrhythmogenic foci within the muscular sleeves that extend not only into the pulmonary veins but also into both vena cavae. The superior vena cava (SVC) is a key target site for catheter ablation. Patients with SVC-derived AF often lack the clinical risk factors of AF.Methods and Results:We conducted a meta-analysis of the clinical and genetic factors of 2,170 AF patients with and without SVC arrhythmogenicity. In agreement with previous reports, the left atrial diameter was smaller in AF patients with SVC arrhythmogenicity. Among 6 variants identified in a previous genome-wide association study in Japanese patients, rs2634073 and rs6584555 were associated with SVC arrhythmogenicity. This finding was confirmed in our meta-analysis using independent cohorts. We also found that SVC arrhythmogenicity was conditionally dependent on age, body mass index, and left ventricular ejection fraction.
Both clinical and genetic factors are associated with SVC arrhythmogenicity.
心房颤动（AF）可由延伸至肺静脉和双侧腔静脉的心肌袖内致心律失常灶引发。上腔静脉（SVC）是导管消融的关键靶点。源自 SVC 的 AF 患者通常缺乏 AF 的临床危险因素。
我们对 2170 例有和无 SVC 致心律失常性的 AF 患者的临床和遗传因素进行了荟萃分析。与先前的报告一致，SVC 致心律失常性 AF 患者的左心房直径较小。在先前对日本患者进行的全基因组关联研究中鉴定的 6 个变异体中，rs2634073 和 rs6584555 与 SVC 致心律失常性相关。我们使用独立队列的荟萃分析证实了这一发现。我们还发现，SVC 致心律失常性与年龄、体重指数和左心室射血分数呈条件依赖性相关。
临床和遗传因素均与 SVC 致心律失常性相关。
