Abstract 11613: Characteristics of Adenosine Induced Acute Dormant Superior Vena Cava Conduction
Background: Ectopic foci originating from the superior vena cava (SVC) may act as triggers in the occurrence and perpetuation of atrial fibrillation. Transient reconnection of the isolated pulmonary (PV) vein is induced by administration of adenosine triphosphate (ATP) and elimination of dormant conduction improves outcome of atrial fibrillation ablation. Characteristics and frequency of dormant conduction of SVC remained to be elucidated.
Methods: Twenty-eight patients (age 62±11, men 22) underwent SVC isolation after pulmonary vein isolation. Irrigated ablation catheters were used with the max power 30W in the anterior, septal and posterior site of SVC, and 25W in the lateral site near the phrenic nerve. ATP (20mg) was given greater than 10 minutes after SVC isolation to reveal dormant conduction.
Results: SVC isolation was achieved all patients. Dormant conduction was observed in 22% (7/28), including transient SVC reconnection in 21% (6/28), and persistent SVC conduction in 4% (1/28). 86% of dormant conduction of SVC was induced near the phrenic nerve. Re-ablating carefully, all dormant conduction was eliminated. Only one patient needed administration of ATP three times. No complications were observed including sinus node dysfunction and phrenic nerve injury. The frequency of dormant conduction of SVC was not different from that of PV (25 %).
Conclusions: Administration of ATP could reveal dormant conduction of SVC. Dormant conduction of SVC was induced near the phrenic nerve at a rate similar to dormant conduction of PV.
- © 2012 by American Heart Association, Inc.