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KMID : 1011920110120030036
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International Journal of Arrhythmia
2011 Volume.12 No. 3 p.36 ~ p.41
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The different role of persistent left superior vena cava in a patient with atrial fibrillation and atrial tachycardia
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Lee Sang-Hee
Shin Dong-Gu
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Abstract
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We report the case of a 59-year-old man who had a persistent left superior vena cava (PLSVC) and showed paroxysmal atrial fibrillation (PaAF). During electrophysiologic study (EPS), a fragmented electrogram was observed for the PLSVC, and a 3-dimensional electroanatomical map showed electrophysiologic properties that indicated that the PLSVC acted as an arrhythmogenic substrate for PaAF. Atrial fibrillation (AF) changed to a typical flutter after focal ablation at the site with fragmented potential. Atrial tachycardia (AT) developed during follow-up, and another session of EPS showed reentrant atrial flutter at the mitral isthmus. At this time, PLSPV played the role of a bystander and was activated from the entrance site at a proximal part that faced the LA. Thus, our patient had PLSVC that presented as an arrhythmogenic substrate of PaAF and a bystander of AT.
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KEYWORD
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atrial fibrillation, catheter ablation, left superior vena cava
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