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Electrophysiological features and radiofrequency catheter ablation of supraventricular tachycardia in patients with persistent left superior vena cava

 Jae-Sun Uhm  ;  Jong-Il Choi  ;  Yong Soo Baek  ;  Hee Tae Yu  ;  Pil-Sung Yang  ;  Yun Gi Kim  ;  Suk-Kyu Oh  ;  Hee-Soon Park  ;  Kwang No Lee  ;  Tae-Hoon Kim  ;  Jaemin Shim  ;  Boyoung Joung  ;  Hui-Nam Pak  ;  Moon-Hyoung Lee  ;  Young-Hoon Kim 
 HEART RHYTHM, Vol.15(11) : 1634-1641, 2018 
Journal Title
Issue Date
Adult ; Bundle of His/physiopathology* ; Bundle of His/surgery ; Catheter Ablation/methods* ; Echocardiography ; Electrocardiography* ; Female ; Humans ; Male ; Phlebography ; Tachycardia, Supraventricular/physiopathology ; Tachycardia, Supraventricular/surgery* ; Tomography, X-Ray Computed ; Vena Cava, Superior/abnormalities* ; Vena Cava, Superior/diagnostic imaging
Atrioventricular nodal reentrant tachycardia ; Atrioventricular reentrant tachycardia ; Catheter ablation ; Persistent left superior vena cava ; Supraventricular tachycardia
BACKGROUND: The electrophysiological features and roles of persistent left superior vena cava (PLSVC) in supraventricular tachycardia (SVT) are not known. OBJECTIVE: The purpose of this study was to elucidate the electrophysiological features and roles of PLSVC in patients with SVT. METHODS: We included 37 patients with PLSVC (mean age 43.5 ± 17.1 years; 35.1% men) and 510 patients without PLSVC (mean age 43.9 ± 18.8 years; 48.2% men) who underwent an electrophysiology study for SVT. The number of induced tachycardias, location of the slow pathway (SP) or accessory pathway (AP), and radiofrequency catheter ablation (RFCA) outcomes were compared between patients with and without PLSVC. During RFCA of the left AP, a coronary sinus (CS) catheter was placed into the left superior vena cava (left superior vena cava group) or the great cardiac vein (great cardiac vein group). The RFCA outcomes were compared between the groups. RESULTS: In patients with PLSVC, 40 tachycardias were induced: atrioventricular nodal reentrant tachycardia (AVNRT) (n = 19), atrioventricular reentrant tachycardia (n = 17), and focal atrial tachycardia (n = 4). Among patients with AVNRT, an SP in the CS was significantly more frequent in patients with PLSVC than in those without PLSVC (47.4% vs 3.8%; P < .001). In patients with the left AP, the number of RFCA attempts and recurrence were lower in the great cardiac vein group than in the left superior vena cava group. CONCLUSION: An SP in the CS is prevalent in patients with AVNRT and PLSVC. It is useful to place a CS catheter into the great cardiac vein in patients with a left AP and PLSVC.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae-Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-4200-3456
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Yang, Pil Sung(양필성)
Uhm, Jae Sun(엄재선) ORCID logo https://orcid.org/0000-0002-1611-8172
Yu, Hee Tae(유희태) ORCID logo https://orcid.org/0000-0002-6835-4759
Lee, Moon-Hyoung(이문형) ORCID logo https://orcid.org/0000-0002-7268-0741
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
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