Goyal Rajat, Gracia Ely, Fan Roger
Department of Cardiology, Stony Brook University Hospital, Stony Brook, NY.
Department of Internal Medicine, Stony Brook University Hospital, Stony Brook, NY.
J Innov Card Rhythm Manag. 2017 Apr 15;8(4):2674-2680. doi: 10.19102/icrm.2017.080406. eCollection 2017 Apr.
The superior vena cava (SVC) has been identified as one of the most common sources of non-pulmonary vein triggers for atrial fibrillation (AF). SVC isolation has been shown to improve long-term maintenance of normal sinus rhythm in patients with paroxysmal AF. However, ablation at the SVC is associated with risks of phrenic nerve injury, sinus node dysfunction, and SVC stenosis. The use of electroanatomical mapping, intracardiac echocardiography, compound motor action potentials, and segmental (rather than circumferential) ablation are all strategies to reduce complications. Given these risks, SVC isolation is most effective as an adjunct to pulmonary vein isolation for patients with paroxysmal AF who have been found to have an arrhythmogenic SVC.
上腔静脉（SVC）已被确定为心房颤动（AF）非肺静脉触发因素的最常见来源之一。已证明，对于阵发性房颤患者，隔离上腔静脉可改善正常窦性心律的长期维持。然而，在上腔静脉进行消融与膈神经损伤、窦房结功能障碍和上腔静脉狭窄的风险相关。使用电解剖标测、心腔内超声心动图、复合运动动作电位以及节段性（而非环周性）消融都是减少并发症的策略。鉴于这些风险，对于已被发现存在致心律失常性上腔静脉的阵发性房颤患者，隔离上腔静脉作为肺静脉隔离的辅助手段最为有效。
