Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
Pacing Clin Electrophysiol. 2024 Mar;47(3):437-439. doi: 10.1111/pace.14748. Epub 2023 Jun 1.
We report a case of atrial fibrillation (AF) recurrence after pulmonary vein isolation, which patient had AF trigger in the superior vena cava (SVC) near the sinus node (SN). The ultra-high-resolution mapping revealed that SN located within the SVC and the atrial activation from the SN to SVC propagated in both septal and lateral direction, then upward with circumventing the spontaneous conduction block identified just above and lateral SN (upper hemisphere). We successfully isolated SVC including the ectopic origin at the same level as the SN by utilizing the spontaneous conduction block line around the SN without any complication.
我们报告一例肺静脉隔离术后心房颤动（AF）复发的病例，该患者在靠近窦房结（SN）的上腔静脉（SVC）中出现 AF 触发。超高分辨率标测显示 SN 位于 SVC 内，从 SN 到 SVC 的心房激活呈上下双向传导，随后向上绕过 SN 上方和外侧的自发传导阻滞区（上半部分）。我们成功地利用围绕 SN 的自发传导阻滞线，在不产生任何并发症的情况下，在与 SN 同一水平处隔离包括异位起源在内的 SVC。
