Superior vena cava (SVC) is an important source of origin of atrial fibrillation (AF) triggers other than a pulmonary vein. Because of the proximity of SVC-aorta ganglionic plexi to the SVC and the extension of myocardium in the SVC from the right atrium, SVC frequently becomes an important source of ectopic beats initiating AF. The potential complications of SVC isolation may include sinus node injury. Sinus node isolation was observed in a patient who had undergone previous surgical isolation of SVC for AF, while attempting to ablate endocardially, near the superior part of interatrial septum for an atrial tachycardia.
From the Departments of *Cardiology and †Cardiac Surgery, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands; and ‡Admiraal de Ruiter Hospital, Goes, The Netherlands.
Accepted for publication June 3, 2015.
Disclosures: Mark La Meir, MD, PhD, and Laurent Pison, MD, PhD, are consultants for AtriCure, Inc, West Chester, OH USA. Narendra Kumar, MD, PhD, Sandro Gelsomino, MD, PhD, Ismail Aksoy, MD, and Jos Maessen, MD, PhD, declare no conflicts of interest.
Address correspondence and reprint requests to Narendra Kumar, MD, PhD, Department of CTC, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, PO Box 6202AZ, Maastricht, The Netherlands. E-mail: firstname.lastname@example.org.