Matsumoto Sen, Matsunaga-Lee Yasuharu, Masunaga Nobutaka, Takano Yuzuru
Department of Cardiovascular Medicine, JCHO Hoshigaoka Medical Center, Japan.
Department of Cardiovascular Medicine, JCHO Hoshigaoka Medical Center, Japan.
Indian Pacing Electrophysiol J. 2018 Jul-Aug;18(4):155-158. doi: 10.1016/j.ipej.2018.04.003. Epub 2018 Apr 13.
A 69-year-old woman with palpitations was referred to our hospital for a second session of atrial fibrillation (AF) catheter ablation. She had a history of AF ablation including pulmonary vein (PV) isolation and persistent left superior vena cava (PLSVC) isolation. Electrophysiologic studies showed the veno-atrial connections that had recovered. After PV isolation was performed, AF was induced by atrial premature contraction (APC) from the PLSVC, and AF storm occurred. During PLSVC isolation, AF was not induced by APC from the PLSVC. PLSVC isolation continued during sinus rhythm. The elimination of the PLSVC potential was difficult to confirm because of the far-field potential of the left ventricle. Then, we performed right ventricular pacing. The remaining PLSVC potential was identified. After that, the PLSVC isolation was successful during right ventricular pacing. Complications were not observed. The patient had no recurrence of AF thereafter.
一名69岁心悸女性因第二次心房颤动（AF）导管消融术转诊至我院。她有AF消融病史，包括肺静脉（PV）隔离和永存左上腔静脉（PLSVC）隔离。电生理研究显示静脉-心房连接已恢复。在进行PV隔离后，PLSVC的房性早搏（APC）诱发了AF，并发生了AF风暴。在PLSVC隔离期间，PLSVC的APC未诱发AF。在窦性心律期间继续进行PLSVC隔离。由于左心室的远场电位，很难确认PLSVC电位的消除。然后，我们进行了右心室起搏。识别出了剩余的PLSVC电位。此后，在右心室起搏期间PLSVC隔离成功。未观察到并发症。此后患者未再发生AF。
