Structural relation between the superior vena cava and pulmonary veins in patients with atrial fibrillation.
Kentaro YoshidaMasako BabaHideyuki HasebeYasutoshi ShinodaTomohiko HarunariMari EbineYoshiko UeharaHiroaki WatabeNoriyuki TakeyasuHitoshi HorigomeAkihiko NogamiMasaki IedaPublished in: Heart and vessels (2019)
The superior vena cava (SVC) is a main source of non-pulmonary vein (PV) ectopies that initiate atrial fibrillation (AF). Although the critical role of structural remodeling of the left atrium (LA) in the occurrence of AF was extensively investigated by atrial voltage mapping, that of PVs and the SVC has been less explored. Study subjects comprised 47 patients undergoing catheter ablation of lone AF. During sinus rhythm, PV, SVC, and atrial voltage maps were acquired, and sleeve length of each PV and SVC was determined by an electroanatomical mapping system. The sleeves of the superior PVs were significantly longer than those of the inferior PVs (left superior PV (LSPV): 21 ± 5, left inferior PV: 14 ± 4, right superior PV (RSPV): 19 ± 5, right inferior PV: 15 ± 5, and SVC: 23 ± 10 mm, p < 0.0001). The LSPV sleeve was longer in men than in women (22 ± 6 vs. 19 ± 4 mm, p < 0.05). The sleeve length in the LSPV correlated positively with the body surface area (BSA) (p = 0.003, R = 0.42). Of note, there was a significant correlation in sleeve length between the RSPV and SVC (p < 0.0001, R = 0.64). In conclusion, not right- but left-sided PV sleeves were associated with the BSA of the patients, whereas a structural relation between the right-sided PVs and the SVC was implied based on sleeve mapping. This novel finding may provide mechanistic implications for the development of AF in future studies.
Keyphrases
- atrial fibrillation
- catheter ablation
- vena cava
- left atrial
- left atrial appendage
- oral anticoagulants
- direct oral anticoagulants
- inferior vena cava
- patients undergoing
- heart failure
- high resolution
- percutaneous coronary intervention
- end stage renal disease
- newly diagnosed
- polycystic ovary syndrome
- ejection fraction
- chronic kidney disease
- pulmonary hypertension
- prognostic factors
- coronary artery disease
- patient reported
- multidrug resistant
- adipose tissue
- left ventricular
- pulmonary embolism
- mass spectrometry