A new method of superior vena cava isolation without phrenic nerve injury by longitudinal ablation parallel to the phrenic nerve: a case report.

摘要: Background Superior vena cava (SVC) isolation has improved the outcomes of paroxysmal atrial fibrillation (AF) originating from SVC. However, right phrenic nerve (PN) injury is a major complication this procedure. Therefore, in cases where atrium (RA)-SVC conduction site near PN, tremendous care required to prevent PN injury. Case summary Repeated SVC was performed due recurrence SVC-triggered AF. The RA-SVC activation map revealed that partial block line detected, and propagation broke through gap at course RA Since identified high-output pacing wide, isolated by making longitudinal lines on both sides cranial direction, except for low-output captured, confirming compound muscle action potential detect Eventually, successfully without injury, sinus rhythm maintained antiarrhythmic drugs during 14-month follow-up period. Conclusion difficult depending some methods avoid were reported. method can facilitate safe effective with conventional system, including AF foci located PN.