Electrophysiological relation between the superior vena cava and right superior pulmonary vein in patients with paroxysmal atrial fibrillation

Yoshida, Kentaro; Hattori, Ai; Tsuneoka, Hidekazu; Tsumagari, Yasuaki; Yui, Yoshiaki; Kimata, Akira; Ikoma, Yoko; Ebine, Mari; Uehara, Yoshiko; Koda, Naoya; Misaki, Masako; Asaoka, Daisuke; Takeyasu, Noriyuki; Aonuma, Kazutaka; Nogami, Akihiko

doi:10.1111/jce.13286

Cited by 18 publications

(19 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous histological examination in autopsy specimens has shown that PV myocardial sleeves were found in 100% of patients with AF, compared to 85% of patients without AF [30]. The recent studies from voltage map showed that the lengths of myocardial sleeves are longer in the left and right superior PVs but markedly shorter in the left and right inferior PVs [31,32]. Patients with AF have significant longer myocardial sleeves [30].…”

Section: Distinct Electrophysiological and Structural Characteristmentioning

confidence: 99%

Heart Failure Differentially Modulates Natural (Sinoatrial Node) and Ectopic (Pulmonary Veins) Pacemakers: Mechanism and Therapeutic Implication for Atrial Fibrillation

Chan

Lin

Chen

et al. 2019

IJMS

View full text Add to dashboard Cite

Heart failure (HF) frequently coexists with atrial fibrillation (AF) and dysfunction of the sinoatrial node (SAN), the natural pacemaker. HF is associated with chronic adrenergic stimulation, neurohormonal activation, abnormal intracellular calcium handling, elevated cardiac filling pressure and atrial stretch, and fibrosis. Pulmonary veins (PVs), which are the points of onset of ectopic electrical activity, are the most crucial AF triggers. A crosstalk between the SAN and PVs determines PV arrhythmogenesis. HF has different effects on SAN and PV electrophysiological characteristics, which critically modulate the development of AF and sick sinus syndrome. This review provides updates to improve our current understanding of the effects of HF in the electrical activity of the SAN and PVs as well as therapeutic implications for AF.

show abstract

Section: Distinct Electrophysiological and Structural Characteristmentioning

confidence: 99%

Heart Failure Differentially Modulates Natural (Sinoatrial Node) and Ectopic (Pulmonary Veins) Pacemakers: Mechanism and Therapeutic Implication for Atrial Fibrillation

Chan

Lin

Chen

et al. 2019

IJMS

View full text Add to dashboard Cite

show abstract

“…Currently, race and ethnicity and their stratified outcomes are rarely reported in the AF ablation literature, perpetuating this knowledge gap. Investigations of adjunctive lesion sets in homogenous populations by race or ethnicity that demonstrate incremental benefit may not generalize, contributing to reproducibility issues in the field …”

Section: Discussionmentioning

confidence: 99%

“…Investigations of adjunctive lesion sets in homogenous populations by race or ethnicity that demonstrate incremental benefit may not generalize, contributing to reproducibility issues in the field. 18,19 Prior worldwide surveys on AF ablation methods, efficacy, and safety found minimal variation in procedure success rates by geographic region. [1][2][3] However, these surveys are no longer contemporary, rely on proceduralists' self-reported outcomes, do not report country-level data, and do not investigate the effect on outcomes of powerful determinants of reported procedure success (e.g., followup protocols).…”

Section: Incidence Of Af Is Lower In Asians and Africans As Compared Tomentioning

confidence: 99%

Geographic and racial representation and reported success rates of studies of catheter ablation for atrial fibrillation: Findings from the SMASH‐AF meta‐analysis study cohort

Leef

Perino

Cluckey

et al. 2018

Cardiovasc electrophysiol

View full text Add to dashboard Cite

Studies of AF ablation have substantial variation in patient demographics, study design, and reported outcomes by country. There is limited geographic representation of trials and observational studies of AF ablation and a paucity of race- or ethnicity-stratified results. Future AF ablation studies and registries should aim to have broad representation by race, geography, and ethnicity to ensure generalizability.

show abstract

“…Thereafter, a cavotricuspid isthmus line was created, with an endpoint of bidirectional conduction block [ 7 ]. If non-PV ectopies were reproducibly observed with and without the continuous infusion of isoproterenol (1–4 mcg/min), they were targeted for ablation [ 13 , 14 , 15 , 16 , 17 ]. Neither ablation of continuous fractionated atrial electrograms nor left atrial linear ablation was performed in this series in the index procedures.…”

Section: Methodsmentioning

confidence: 99%

Predictors of Recurrence after Catheter Ablation of Paroxysmal Atrial Fibrillation in Different Follow-Up Periods

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background and objectives: Pulmonary vein (PV) reconnection is a major reason for recurrence after catheter ablation of paroxysmal atrial fibrillation (PAF). However, the timing of the recurrence varies between patients, and recurrence >1 year after ablation is not uncommon. We sought to elucidate the characteristics of atrial fibrillation (AF) that recurred in different follow-up periods. Materials and Methods: Study subjects comprised 151 consecutive patients undergoing initial catheter ablation of PAF. Left atrial volume index (LAVi) and atrial/brain natriuretic peptide (ANP/BNP) levels were systematically measured annually over 3 years until AF recurred. Results: Study subjects were classified into four groups: non-recurrence group (n = 84), and short-term- (within 1 year) (n = 30), mid-term- (1–3 years) (n = 26), and long-term-recurrence group (>3 years) (n = 11). The short-term-recurrence group was characterized by a higher prevalence of diabetes mellitus (hazard ratio 2.639 (95% confidence interval, 1.174–5.932), p = 0.019 by the Cox method), frequent AF episodes (≥1/week) before ablation (4.038 (1.545–10.557), p = 0.004), and higher BNP level at baseline (per 10 pg/mL) (1.054 (1.029–1.081), p < 0.0001). The mid-term-recurrence group was associated with higher BNP level (1.163 (1.070–1.265), p = 0.0004), larger LAVi (mL/m2) (1.033 (1.007–1.060), p = 0.013), and longer AF cycle length at baseline (per 10 ms) (1.194 (1.058–1.348), p = 0.004). In the long-term-recurrence group, the ANP and BNP levels were low throughout follow-up, as with those in the non-recurrence group, and AF cycle length was shorter (0.694 (0.522–0.924), p = 0.012) than those in the other recurrence groups. Conclusions: Distinct characteristics of AF were found according to the time to first recurrence after PAF ablation. The presence of secondary factors beyond PV reconnections could be considered as mechanisms for the recurrence of PAF in each follow-up period.

show abstract

Electrophysiological relation between the superior vena cava and right superior pulmonary vein in patients with paroxysmal atrial fibrillation

Abstract: An electrophysiological interrelation may be present between the SVC and RSPV in patients with paroxysmal AF. Semiempiric SVC isolation limited to patients with an arrhythmogenic RSPV may be a more efficient treatment strategy.

Cited by 18 publications

References 25 publications

Heart Failure Differentially Modulates Natural (Sinoatrial Node) and Ectopic (Pulmonary Veins) Pacemakers: Mechanism and Therapeutic Implication for Atrial Fibrillation

Heart Failure Differentially Modulates Natural (Sinoatrial Node) and Ectopic (Pulmonary Veins) Pacemakers: Mechanism and Therapeutic Implication for Atrial Fibrillation

Geographic and racial representation and reported success rates of studies of catheter ablation for atrial fibrillation: Findings from the SMASH‐AF meta‐analysis study cohort

Predictors of Recurrence after Catheter Ablation of Paroxysmal Atrial Fibrillation in Different Follow-Up Periods

Contact Info

Product

Resources

About