Electroanatomic mapping in atrioventricular junction ablation and pacemaker implantation for permanent atrial fibrillation associated with persistent left superior vena cava

Electroanatomic mapping in atrioventricular junction ablation during sinus rhythm for tachycardia‐bradycardia syndrome with persistent left superior vena cava

“…Because of lack of effectiveness, the catheter tip was gradually positioned more towards the atrial aspect where His bundle electrograms were no longer seen. This was performed owing to prior reported experience 1 . During ablation lesion #7, transient interruption of AV conduction was observed.…”

“…This was performed owing to prior reported experience. 1 During ablation lesion #7, transient interruption of AV conduction was observed.…”

“…A recent publication from our institution was the first description of an electroanatomic mapping (EAM) system to facilitate atrioventricular (AV) junction ablation and pacemaker implantation, or “ablate and pace,” in a patient with permanent atrial fibrillation (AF) and a persistent left superior vena cava (PLSVC). 1 Novel findings for catheter ablation included the abnormal location of the AV node in the right superior AV junction segment and the lack of distinct electrograms at the successful site, which was performed during AF. Herein, we report the first description of AV junction ablation performed during sinus rhythm in a patient with paroxysmal AF and PLSVC.…”

“…This patient and the prior patient‐reported from our institution illustrate the high variability in anatomic and electrogram characteristics for patients with PLSVC who undergo AV junction ablation. 1 EAM systems and awareness of these variations may decrease procedure time, decrease fluoroscopy time, and minimize delivery of ineffective ablation lesions.…”