Transient sinus node dysfunction following sinus node artery occlusion due to radiofrequency catheter ablation of the septal superior vena cava–right atrium junction

Kitamura, Τakeshi; Fukamizu, Seiji; Arai, Ken; Hojo, Rintaro; Aoyama, Yuya; Komiyama, Kanki; Sakurada, Harumizu; Hiraoka, Masayasu

doi:10.1016/j.jelectrocard.2015.11.001

Cited by 24 publications

(20 citation statements)

References 6 publications

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“…Another possible mechanism of the VR is the transient ischemic injury of the sinus node artery during the cryoballoon ablation procedure. Previous reports showed that a sinus node artery dominantly originating from left circumflex artery courses over the anterior LA, and that the proximity of the ablation application site to the endocardium of LA could disrupt the artery flow, resulting in bradycardia [23,24]. The present study showed that some patients, but not all of the VR patients, exhibited a well‐developed sinus node artery branching from the left circumflex artery.…”

Section: Discussionsupporting

confidence: 50%

Vagal response in cryoballoon ablation of atrial fibrillation and autonomic nervous system: Utility of epicardial adipose tissue location

Inden

Mizutani

Fujii

et al. 2017

Journal of Arrhythmia

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BackgroundMechanism and effects of vagal response (VR) during cryoballoon ablation procedure on the cardiac autonomic nervous system (ANS) are unclear. The present study aimed to evaluate the relationship between VR during cryoballoon catheter ablation for atrial fibrillation and ANS modulation by evaluating epicardial adipose tissue (EAT) locations and heart rate variability (HRV) analysis.MethodsForty-one patients with paroxysmal atrial fibrillation (11 with VR during the procedure and 30 without VR) who underwent second-generation cryoballoon ablation were included. EAT locations and changes in HRV parameters were compared between the VR and non-VR groups, using Holter monitoring before ablation, immediately after ablation and one month after ablation.ResultsThe total EAT volume surrounding the left atrium (LA) in the VR and non-VR groups was 29.0±18.4 cm3 vs 27.7±19.7 cm3, respectively (p=0.847). The VR group exhibited greater EAT volume overlaying the LA-left superior pulmonary vein (PV) junction (6.1±3.6 cm3 vs 3.6±3.3 cm3, p=0.039) than the non-VR group. HRV parameters similarly changed following ablation in both the groups. EAT volume overlaying LA-right superior PV junction was significantly correlated with the relative changes in root-mean-square successive differences (r=−0.317, p=0.043) and high frequency (r=−0.331, p=0.034), immediately after the ablation.ConclusionsChanges in HRV parameters following ablation were similarly observed in both the groups. EAT volume on the LA-PV junction is helpful for interpretation of VR occurrence and ANS modulation.

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Section: Discussionsupporting

confidence: 50%

Vagal response in cryoballoon ablation of atrial fibrillation and autonomic nervous system: Utility of epicardial adipose tissue location

Inden

Mizutani

Fujii

et al. 2017

Journal of Arrhythmia

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“…However, most procedures required RF deliveries in that area to complete the electrical SVC isolation and this method might also be a nonspecific prediction of PN injury due to the dependence on the contact force and power 17,20 . Permanent SN injury requiring pacemaker implantation during the RF‐SVC isolation was reported in several studies 18,21 . Possible explanations were the injury of SNe artery and the irreversible RF thermal energy.…”

Section: Discussionmentioning

confidence: 99%

Electrical isolation of the superior vena cava using second‐generation cryoballoon in patients with atrial fibrillation

Wei

Guo

Sun

et al. 2020

Cardiovasc electrophysiol

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Background: The safety and efficacy of superior vena cava (SVC) isolation using second-generation cryoballoon (CB) ablation remain unknown.Methods: A total of 26 (3.2%) patients with SVC-related paroxysmal atrial fibrillation (AF) from a consecutive series of 806 patients who underwent secondgeneration CB were included. Pulmonary vein isolation was initially achieved by CB ablation. If the SVC trigger was determined, the electrical isolation of SVC isolation was performed using the second-generation CB. Results: Real-time SVC potential was observed in all patients. Isolation of the SVC was successfully accomplished in 21 (80.8%) patients. The mean number of freeze cycles in each patient was 2.1 ± 1.1. The mean time to isolation and ablation duration were 22.5 ± 14.2 seconds and 94.5 ± 22.3 seconds, respectively. A transient phrenic nerve (PN) injury was observed in five patients (19.2%). There were two patients (7.7%) experienced reversible sinus node injury during the first application. During a mean follow-up period of 13.2 ± 5.8 months, four patients (15.4%) had atrial arrhythmia recurrences. Conclusion: Isolation of SVC using the second-generation 28-mm CB is feasible when SVC driver during AF is identified. Vigilant monitoring of PN function during CB ablation of SVC is needed to avoid PN injury. K E Y W O R D S catheter ablation, cryoballoon, phrenic nerve, sinus node, superior vena cava

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“…Others have described a more transient sinus node dysfunction due to occlusion of the sinus node artery. 1235 …”

Section: Section 10: Complicationsmentioning

confidence: 99%

2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation

et al. 2017

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Transient sinus node dysfunction following sinus node artery occlusion due to radiofrequency catheter ablation of the septal superior vena cava–right atrium junction

Cited by 24 publications

References 6 publications

Vagal response in cryoballoon ablation of atrial fibrillation and autonomic nervous system: Utility of epicardial adipose tissue location

Vagal response in cryoballoon ablation of atrial fibrillation and autonomic nervous system: Utility of epicardial adipose tissue location

Electrical isolation of the superior vena cava using second‐generation cryoballoon in patients with atrial fibrillation

2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation

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