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Heart and Vessels

, Volume 34, Issue 12, pp 2052–2058 | Cite as

Structural relation between the superior vena cava and pulmonary veins in patients with atrial fibrillation

  • Kentaro YoshidaEmail author
  • Masako Baba
  • Hideyuki Hasebe
  • Yasutoshi Shinoda
  • Tomohiko Harunari
  • Mari Ebine
  • Yoshiko Uehara
  • Hiroaki Watabe
  • Noriyuki Takeyasu
  • Hitoshi Horigome
  • Akihiko Nogami
  • Masaki Ieda
Short Communication
  • 109 Downloads

Abstract

The superior vena cava (SVC) is a main source of non-pulmonary vein (PV) ectopies that initiate atrial fibrillation (AF). Although the critical role of structural remodeling of the left atrium (LA) in the occurrence of AF was extensively investigated by atrial voltage mapping, that of PVs and the SVC has been less explored. Study subjects comprised 47 patients undergoing catheter ablation of lone AF. During sinus rhythm, PV, SVC, and atrial voltage maps were acquired, and sleeve length of each PV and SVC was determined by an electroanatomical mapping system. The sleeves of the superior PVs were significantly longer than those of the inferior PVs (left superior PV (LSPV): 21 ± 5, left inferior PV: 14 ± 4, right superior PV (RSPV): 19 ± 5, right inferior PV: 15 ± 5, and SVC: 23 ± 10 mm, p < 0.0001). The LSPV sleeve was longer in men than in women (22 ± 6 vs. 19 ± 4 mm, p < 0.05). The sleeve length in the LSPV correlated positively with the body surface area (BSA) (p = 0.003, R = 0.42). Of note, there was a significant correlation in sleeve length between the RSPV and SVC (p < 0.0001, R = 0.64). In conclusion, not right- but left-sided PV sleeves were associated with the BSA of the patients, whereas a structural relation between the right-sided PVs and the SVC was implied based on sleeve mapping. This novel finding may provide mechanistic implications for the development of AF in future studies.

Keywords

Catheter ablation Atrial fibrillation Pulmonary vein Superior vena cava Sleeve Remodeling 

Notes

Funding

None.

Compliance with ethical standards

Conflict of interest

Dr. Nogami has received honoraria from Abbott and an endowment from Medtronic and Johnson and Johnson. The other authors report no conflicts.

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Copyright information

© Springer Japan KK, part of Springer Nature 2019

Authors and Affiliations

  • Kentaro Yoshida
    • 1
    • 2
    Email author
  • Masako Baba
    • 1
  • Hideyuki Hasebe
    • 2
  • Yasutoshi Shinoda
    • 1
    • 2
  • Tomohiko Harunari
    • 1
    • 2
  • Mari Ebine
    • 1
  • Yoshiko Uehara
    • 1
  • Hiroaki Watabe
    • 1
  • Noriyuki Takeyasu
    • 1
  • Hitoshi Horigome
    • 3
  • Akihiko Nogami
    • 2
  • Masaki Ieda
    • 2
  1. 1.Department of CardiologyIbaraki Prefectural Central HospitalKasamaJapan
  2. 2.Department of Cardiology, Faculty of MedicineUniversity of TsukubaTsukubaJapan
  3. 3.Department of Pediatrics, Faculty of MedicineUniversity of TsukubaTsukubaJapan

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