Abstract
A case with two different types of atrial reentrant tachycardia of superior vena cava (SVC) origin is presented. Recent clinical studies have shown that the origin of focal atrial tachycardia typically lies in the venous structures connecting to both atria—the coronary sinus, the superior and inferior vena cava, and the pulmonary vein. These foci have atrial muscle fiber extensions which have electrophysiological characteristics essential to generation of focal ectopic firing. However, little is known about reentrant mechanism of these venous structures. In this report, we present a case of two atrial tachycardias (SVT1 and SVT2) independently originating from the SVC. SVT1 had 430 ms of tachycardia cycle length, and SVT2 had 390 ms of tachycardia cycle length. Both of them showed the character of reentry, and their earliest activations were recorded in the SVC. They were successfully eliminated by focal radiofrequency ablation in the SVC.
References
Nathan H, Eliaki M. The junction between the left atrium and the pulmonary veins: an anatomic study of human hearts. Circulation 1966;34:412–422.
Zipes DP, Knope RF. Electrical properties of the thoracic veins. Am J Cardiol. 1972;29:372–376.
Nathan H, Gloobe H. Myocardial atrio-venous junctions and extensions (sleeves) over the pulmonary and caval veins. Anatomical observation in various mammals. Thorax. 1970;25:317–324
Chen SA, Chiang CE, Yang CJ, Cheng CC, Wu TJ, Wang SP, Chiang BN, Chang MS. Sustained atrial tachycardia in adult patients; electrophysiological characteristics, pharmacological response, possible mechanisms, and effects of radiofrequency ablation. Circulation. 1994;90:1262–1278
Ino T, Miyamoto S, Ohno T, Tadara T. Exit block of focal repetitive activity in the superior vena cava masquerading as a high right atrial tachycardia. J Cardiovasc Electrophysiol 2000;11:480–483
Tsai CF, Tai CT, Hsieh MH, Lin WS, Yu WC, Ueng KC, Ding YA, Cheng MS, Chen SA. Initiation of atrial fibrillation by ectopic beats originating from the superior vena cava: electrophysiological characteristics and results of radiofrequency ablation. Circulation 2000;102:67–74
Chang KC, Lin YC, Chen JY, Chou HT, Hung JS. Electrophysiological characteristics and radiofrequency ablation of focal atrial tachycardia originating from the superior vena cava. Jpn Circ J 2001;65:1034–1040
Dong J, Schreick J, Ndrepepa G, Schmitt C. Ectopic tachycardia originating from the superior vena cava. J Cardiovasc Electrophysiol 2002;13:620–624
Liu TY, Tai CT, Lee PC, Hsieh MH, Higa S, Ding YA, Chen SA. Novel concept of atrial tachyarrhythmias originating from the superior vena cava: insight from noncontact mapping. J Cardiovasc Electrophysiol 2003;14:533–539
Shah DC, Haissaguerre M, Jais P, Clementy J. High-resolution mapping of tachycardia originating from the superior vena cava: evidence of electrical heterogeneity, slow conduction, and possible circus movement reentry. J Cardiovasc Electrophysiol 2002; 13:388–392
Okamoto K, Ito H, Kuma F, Koike A, Shimoike E, Ueda N, Maruyama T, Kaji Y, Fujino T. Reentrant atrial tachycardia originating from the superior vena cava. J Interv Card Electrophysiol 2003;8:203–208
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Mizobuchi, M., Enjoji, Y., Shibata, K. et al. Two atrial reentrant tachycardias originating from the superior vena cava: Electrophysiological characteristics and radiofrequency ablation. J Interv Card Electrophysiol 15, 43–47 (2006). https://doi.org/10.1007/s10840-006-6720-1
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DOI: https://doi.org/10.1007/s10840-006-6720-1