The usefulness of ventricular pacing during atrial fibrillation ablation in a persistent left superior vena cava: A case report

Sen Matsumoto; Yasuharu Matsunaga-Lee; Nobutaka Masunaga; Yuzuru Takano

doi:10.1016/j.ipej.2018.04.003

The usefulness of ventricular pacing during atrial fibrillation ablation in a persistent left superior vena cava: A case report

Indian Pacing Electrophysiol J. 2018 Jul-Aug;18(4):155-158. doi: 10.1016/j.ipej.2018.04.003. Epub 2018 Apr 13.

Authors

Sen Matsumoto¹, Yasuharu Matsunaga-Lee², Nobutaka Masunaga², Yuzuru Takano²

Affiliations

¹ Department of Cardiovascular Medicine, JCHO Hoshigaoka Medical Center, Japan. Electronic address: mir19219434a@gmail.com.
² Department of Cardiovascular Medicine, JCHO Hoshigaoka Medical Center, Japan.

Abstract

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.

Keywords: Atrial fibrillation; Catheter ablation; Non-pulmonary vein foci; Persistent left superior vena cava; Ventricular pacing.