Initiation of atrial fibrillation by ectopic beats originating from the superior vena cava: Electrophysiological characteristics and results of radiofrequency ablation

Chin Feng Tsai, Ching Tai Tai, Ming Hsiung Hsieh, Wei Shiang Lin, Wen Chung Yu, Kwo Chang Ueng, Yu An Ding, Mau Song Chang, Shih Ann Chen

Research output: Contribution to journalArticlepeer-review

429 Citations (Scopus)

Abstract

Background - The superior vena cava (SVC) has cardiac musculature extending from the right atrium. However, no previous study in humans has given details regarding the ectopic foci that initiate paroxysmal atrial fibrillation (PAF), which may originate from the SVC. Methods and Results - A total of 130 patients with frequent attacks of PAF initiated by ectopic beats were included. Eight patients (6%) had spontaneous AF initiated by a burst of rapid ectopic beats from the SVC (located 19±7 mm above the junction of the SVC and right atrium), which was confirmed by multiplane angiographic and intracardiac echocardiographic visualization and was marked by a sharp SVC potential preceding atrial activity. During initial repetitive discharges, the group with SVC ectopy had a higher incidence of intravenous conduction block than the group with pulmonary vein ectopy (75% versus 37%; P=0.03). The activation time of the earliest intracardiac ectopic activities relative to ectopic P wave onset was significantly shorter in the SVC ectopy than the pulmonary vein ectopy group (37±15 versus 84±32 ms; P

Original languageEnglish
Pages (from-to)67-74
Number of pages8
JournalCirculation
Volume102
Issue number1
Publication statusPublished - Jul 4 2000
Externally publishedYes

Keywords

  • Catheter ablation
  • Fibrillation
  • Superior
  • Vena cava

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

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