scholarly journals Empirical superior vena cava isolation in patients undergoing redo- catheter ablation procedure after recurrence of atrial fibrillation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
F Spies ◽  
A Madaffari ◽  
G Voellmin ◽  
P Krisai ◽  
N Schaerli ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Success Rates ◽  
Electroanatomic Mapping System ◽  
Kaplan Meier ◽  
Mapping System ◽  
Af Recurrence

Abstract Background/Introduction Extra pulmonary vein (PV) foci may trigger AF recurrence after an initially successful PVI. Superior vena cava (SVC) catheter ablation (CA) may therefore offer a treatment target in order to improve success rates. Purpose The purpose of this study was to evaluate the potential benefit of empirical SVC isolation in addition to PVI in patients undergoing a second CA after index PVI. Methods We retrospectively analyzed consecutive patients scheduled for a second CA because of a recurrence of symptomatic AF. Redo-CA was performed with a 3D electroanatomic mapping system and point-by-point ablation using RF energy in the range between 25 W and 30 W. In case of persistent isolation of all PVs, only SVCI was performed. In case of reconnection of vein(s), a wider antral re-isolation was performed. Redo-PVI (PVI-group) or Redo-PVI plus SVC isolation (SVCI) (PVIplusSVCI-group) were performed at the discretion of the operator. No additional targets were allowed. The endpoint of all procedures was elimination of the PV signals confirmed by a circular mapping catheter at the level of the PV ostium and elimination of all signals in the SVC in case of SVCI. Recurrence of AF during a follow-up of 12 months is presented. Results We analyzed 191 patients (age 61±10 years, 30% female, BMI 27±5 kg/m2, LVEF 56±9%, PLAX 41±7 mm, paroxysmal 61%). Whereas 148 (78%) patients underwent Redo-PVI only, 31 patients (16%) underwent PVI plus SVCI, and in 12 patients (6%) SVCI only was performed. Baseline characteristics did not differ significantly between the two groups. In the PVI-group, 79% were recurrence-free compared to 65% (see Kaplan-Meier curve: log rank p=0.011) in the PVIplusSVCI-group. The RF time of the PVI group focusing on the wide antral re-isolation of vein(s) was significantly higher than for the PVIplusSVCI-group (819±494 s versus 458±444 s; p<0.001). Conclusion Additional empirical SVCI at redo-PVI in patients with symptomatic AF recurrence does not lead to an increase in freedom from AF recurrence. Focusing on an additional “wider antral” re-isolation may be more effective. Kaplan-Meier Survival Curves for Recurre Funding Acknowledgement Type of funding source: None

scholarly journals Long-Term Follow-Up Result of Catheter Ablation in Atrial Fibrillation Initiating from Superior Vena Cava

2011 ◽  
Vol 27 (Supplement) ◽  
pp. BPC_1
Author(s):  
Hung-Yu Chang ◽  
Li-Wei Lo ◽  
Yenn-Jiang Lin ◽  
Shih-Lin Chang ◽  
Yu-Feng Hu ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Long Term Follow Up

Partial Anomalous Pulmonary Venous Connection: Forty-Six Years of Follow-Up

2021 ◽  
Vol 12 (1) ◽  
pp. 70-75
Author(s):  
Anne Kathrine M. Nielsen ◽  
Vibeke E. Hjortdal
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Sinus Node ◽  
Vena Cava ◽  
Node Disease ◽  
Sinus Node Disease ◽  
Patch Technique ◽  
Anomalous Pulmonary Venous Connection

Background: Surgical repair of partial anomalous pulmonary venous connection (PAPVC) may disturb the electrical conduction in the atria. This study documents long-term outcomes, including the late occurrence of atrial tachyarrhythmia and bradyarrhythmia. Methods: This retrospective study covers all PAPVC operations at Aarhus University Hospital between 1970 and 2010. Outcome measures were arrhythmias, sinus node disease, pacemaker implantation, pathway stenosis (pulmonary vein(s), intra-atrial pathway, and/or superior vena cava), and mortality. Data were collected from databases, surgical protocols, and hospital records until May 2018. Results: A total of 83 patients were included with a postoperative follow-up period up to 46 years. Average age at follow-up was 43 ± 21 years. During follow-up, new-onset atrial fibrillation or atrial flutter appeared in four patients (5%). Sinus node disease was present in nine patients (11%). A permanent pacemaker was implanted in seven patients (8%) at an average of 12.7 years after surgery. Pulmonary venous and/or superior vena cava obstruction was seen in five patients (6%). Stenosis was most prevalent in the two-patch technique, and arrhythmia was most prevalent in the single-patch technique. Sixty-seven (81%) of 83 patients had neither bradyarrhythmias nor tachyarrhythmias or pacemaker need. Conclusions: This study contributes important long-term data concerning the course of patients who have undergone repair of PAPVC. It confirms that PAPVC can be operated with low postoperative morbidity. However, late-onset stenosis, bradyarrhythmias and tachyarrhythmias, and need for pacemaker call for continued follow-up.

Sinus Node Injury as a Result of Superior Vena Cava Isolation during Catheter Ablation for Atrial Fibrillation and Atrial Flutter

2010 ◽  
Vol 34 (2) ◽  
pp. 163-170 ◽  
Author(s):  
GANG CHEN ◽  
JIAN ZENG DONG ◽  
XING PENG LIU ◽  
XIN YONG ZHANG ◽  
DE YONG LONG ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Atrial Flutter ◽  
Superior Vena Cava ◽  
Superior Vena ◽  
Sinus Node ◽  
Vena Cava

Femorally inserted central venous catheter in patients with superior vena cava obstruction: choice of the optimal exit site

2016 ◽  
Vol 18 (1) ◽  
pp. 82-88 ◽  
Author(s):  
Jinghui Zhang ◽  
Siyuan Tang ◽  
Chengping Hu ◽  
Cailan Zhang ◽  
Lianxiang He ◽  
...  
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Patient Comfort ◽  
Success Rates ◽  
Exit Site ◽  
Superior Vena Cava Obstruction ◽  
Exit Site Infection ◽  
Pain Scores ◽  
Indwelling Time

Purpose This study assessed patient comfort and catheter indwelling time and decreased incidence of complications in patients with femorally inserted venous catheters (FIVCs) via different exit sites. Methods A group of 114 patients suffering from lung cancer complicated by superior vena cava obstruction (SVCO) underwent femoral insertion of venous catheters to facilitate chemotherapy infusion. Patients were divided into two groups: a novel (NOV) group (n = 59) with the FIVC exit site at the mid-thigh and a conventional (CON) group (n = 55) with the exit site at the groin. The clinical efficacy and safety were compared. Results There were significant differences (p<0.001) between NOV and CON groups in bleeding scores (2.44 ± 0.62 vs. 1.36 ± 0.49), catheter indwelling time (195.08 ± 39.19 days vs. 91.53 ± 32.88 days), patient comfort scores (4.20 ± 0.87 vs. 1.35 ± 0.91), and pain scores (1.64 ± 0.91 vs. 2.42 ± 1.08). Significant differences (p<0.05) were also observed in catheter-associated thrombosis (1.69% vs. 14.55%), catheter exit site infection (1.69% vs. 21.82%), and the incidence of total complications (11.86% vs. 45.45%) between the NOV and CON groups. However, the differences in success rates between the NOV and CON groups during the first attempt (98.32% vs. 98.18%) and catheter obstruction (8.48% vs. 9.09%) were not significant (p>0.05). Conclusions Compared with the conventional exit site at the groin, the exit site at the mid-thigh for FIVCs increased patients’ comfort and catheter indwelling time, and decreased the rate of complication and pain scores. However, it did not decrease the success rate in SVCO patients.

scholarly journals An unpublished case of focal infection on a vascular endoprosthesis graft

2018 ◽  
Vol 24 (1) ◽  
pp. 33-35
Author(s):  
Corentin Buron ◽  
Sylvie Boisramé ◽  
Claire De Moreuil ◽  
Alexandra Le Duc-Pennec ◽  
Rozenn Le Berre
Keyword(s):  
Superior Vena Cava ◽  
Vascular Graft ◽  
Superior Vena ◽  
Vena Cava ◽  
Prosthetic Graft ◽  
Essential Elements ◽  
Blood Cultures ◽  
Associated Lesions ◽  
Focal Infection

Observation: A patient with a prosthetic superior vena cava graft had complications of thrombosis and infection. The blood cultures were positive for Peptostreptococcus micros and Prevotella denticola. The latter are known to exist in oral cavities. Clinical and radiological examinations of the oral cavity revealed the presence of oral infectious foci. Commentary: Superior vena cava prosthetic graft infections of oral origin have not previously been described in the literature. The highlighting of oral infectious foci, their eradication, and the follow-up of patients who had been subject to a vascular graft procedures are essential elements in preventing any associated lesions.

Superior Vena Cava Rupture Caused During Balloon Dilation for Treatment of SVC Syndrome Due to Repetitive Catheter Ablation

Angiology ◽  
2006 ◽  
Vol 57 (2) ◽  
pp. 247-249 ◽  
Author(s):  
Kiyohiro Oshima ◽  
Toru Takahashi ◽  
Susumu Ishikawa ◽  
Toshiteru Nagashima ◽  
Keitaro Hirai ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Superior Vena Cava ◽  
Superior Vena ◽  
Balloon Dilation ◽  
Vena Cava ◽  
Svc Syndrome

scholarly journals Long-term follow-up after prosthetic replacement of the superior vena cava combined with resection of mediastinal-pulmonary malignant tumors

1991 ◽  
Vol 102 (2) ◽  
pp. 259-265 ◽  
Author(s):  
Philippe G. Dartevelle ◽  
Alain R. Chapelier ◽  
Ugo Pastorino ◽  
Pierre Corbi ◽  
Bernard Lenot ◽  
...  
Keyword(s):  
Superior Vena Cava ◽  
Malignant Tumors ◽  
Superior Vena ◽  
Vena Cava ◽  
Prosthetic Replacement ◽  
Long Term Follow Up

Catheter ablation of atrial fibrillation in patients with persistent left superior vena cava is associated with major intraprocedural complications

Heart Rhythm ◽  
2010 ◽  
Vol 7 (12) ◽  
pp. 1755-1760 ◽  
Author(s):  
Erik Wissner ◽  
Roland Tilz ◽  
Melanie Konstantinidou ◽  
Andreas Metzner ◽  
Boris Schmidt ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena

Direct Femoral Cannulation in Minimal Invasive Pediatric Cardiac Surgery

2018 ◽  
Vol 13 (4) ◽  
pp. 300-304 ◽  
Author(s):  
Vivek A. Wadhawa ◽  
Kartik G. Patel ◽  
Chirag P. Doshi ◽  
Jigar K. Shah ◽  
Jaydip A. Ramani ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Minimally Invasive ◽  
Superior Vena Cava ◽  
Femoral Artery ◽  
Superior Vena ◽  
Femoral Vein ◽  
Vena Cava ◽  
Pediatric Cardiac Surgery

Objective One of the major challenges faced in minimally invasive pediatric cardiac surgery is cannulation strategy for cardiopulmonary bypass. Central aortic cannulation through the same incision has been the usual strategy, but it has the disadvantage of cluttering of the operative field. We hereby present the results of femoral cannulation in minimally invasive pediatric cardiac surgery in terms of adequacy and safety. Methods From January 2013 to June 2016, 200 children (122 males) with mean ± SD age of 9.2 ± 4.51 years (median = 6 years, range = 3–18 years) and weight of 19.22 ± 8.49 kg (median = 15 kg, range = 8–45 kg) were operated for congenital cardiac defects through anterolateral thoracotomy. The most common diagnosis was atrial septal defect (144 patients). In all the patients, femoral artery and femoral vein were cannulated along with direct superior vena cava cannulation for institution of cardiopulmonary bypass. Results There were no deaths or any major complications related to femoral cannulation. Femoral artery cannulation provided adequate arterial inflow, whereas femoral vein with direct superior vena cava cannulation provided adequate venous return in all the patients. No patient required vacuum-assisted venous drainage. No patient required conversion to sternotomy or developed vascular, neurological complications. At discharge and at 1-year follow-up, both femoral artery and vein were patent without a significant stenosis on color Doppler ultrasonography in all the patients. At mean ± SD follow-up period of 30.63 ± 10.09 months, all the patients were doing well without any wound-related, neurological, or vascular complications. Conclusions Femoral arterial and venous cannulation is a feasible, reliable, and efficient method for institution of cardiopulmonary bypass in minimally invasive pediatric cardiac surgery.

Sign in / Sign up

Export Citation Format

Share Document