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Focal Atrial Tachycardia Arising from the Inferior Vena Cava

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The inferior vena cava (IVC) is a rare site of focal atrial tachycardia (AT). Here, we report a 20-year-old woman who underwent catheter ablation for anti-arrhythmic drug-resistant AT originating from the IVC. She had undergone open-heart surgery for patch closure of an atrial septal defect 17 years previously and permanent pacemaker implantation for sinus node dysfunction 6 years previously. The AT focus was at the anterolateral aspect of the IVC-right atrial junction, and it was successfully ablated underthree-dimensional electroanatomical-mapping guidance. We suspect that the mechanism of this tachycardia was associated with previous IVC cannulation for open-heart surgery.

Abstract

The inferior vena cava (IVC) is a rare site of focal atrial tachycardia (AT). Here, we report a 20-year-old woman who underwent catheter ablation for anti-arrhythmic drug-resistant AT originating from the IVC. She had undergone open-heart surgery for patch closure of an atrial septal defect 17 years previously and permanent pacemaker implantation for sinus node dysfunction 6 years previously. The AT focus was at the anterolateral aspect of the IVC-right atrial junction, and it was successfully ablated underthree-dimensional electroanatomical-mapping guidance. We suspect that the mechanism of this tachycardia was associated with previous IVC cannulation for open-heart surgery.

참고문헌 (10)

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  3. Lukac P, "Ablation of atrial tachycardia after surgery for congenital and acquired heart disease using an electroanatomic mapping system:Which circuits to expect in which substrate?", Heart Rhythm, 2, pp.64~72 (2005)
  4. Scavée C, "The inferior vena cava: an exceptional source of atrial fibrillation", J Cardiovasc Electrophysiol, 14, pp.659~662 (2003)
  5. Yamane T, "Focal source of atrial fibrillation arising from the ostium of the inferior vena cava", Circ J, 69, pp.756~759 (2005)
  6. Kato Y, "Focal atrial tachycardia originating from inside the inferior vena cava late after surgical repair of congenital heart defects", Pediatr Cardiol, 32, pp.846~848 (2011)
  7. Higa S, "Focal atrial tachycardia: new insight from noncontact mapping and catheter ablation", Circulation, 109, pp.84~91 (2004)
  8. Katsivas AG, "Electroanatomical mapping of a right atrial tachycardia originating within the inferior vena cava", Hellenic J Cardiol, 45, pp.187~190 (2004)
  9. Murphy JG, "Long-term outcome after surgical repair of isolated atrial septal defect. Follow-up at 27 to 32 years", N Engl J Med, 323, pp.1645~1650 (1990)
  10. Pap R, "Surgical technique and the mechanism of atrial tachycardia late after open heart surgery", J Interv Card Electrophysiol, 35, pp.127~135 (2012)

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