The effect of empirical superior vena cava isolation during total thoracoscopic ablation in patients with persistent atrial fibrillation
10.1186/s42444-023-00105-2
- Author:
Hee‑Jin KWON
1
;
Dong Seop JEONG
;
Seung‑Jung PARK
;
Kyoung‑Min PARK
;
June Soo KIM
;
Young Keun ON
Author Information
1. Division of Cardiology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea
- Publication Type:RESEARCH
- From:International Journal of Arrhythmia
2023;24(4):23-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:In patients with non-paroxysmal AF (atrial fibrillation), various ablation strategies have been attempted to target non-pulmonary vein (PV) foci or to achieve substrate modification beyond pulmonary vein isolation. The efficacy of empirical ablation of the SVC, one of the most common non-PV foci, is unclear. The aim of this study was to investigate the efficacy and safety of additional superior vena cava (SVC) isolation in patients with non-parox‑ ysmal AF undergoing thoracoscopic surgical ablation.
Methods:/results A total of 191 patients with persistent or long-standing persistent AF was enrolled. All patients underwent total thoracoscopic surgical ablation for AF, and half of them also received empirical SVC isolation. We compared the atrial tachyarrhythmia (ATa)-free survival rate and procedure-related complications in the two groups of patients. The 3-year ATa-free survival rate was 53% in the SVC isolation group and 52% in the no-SVC isolation group (p = 0.644). There were no differences between the two groups with respect to AF type or LA size. Procedure-related complications occurred in 12 patients (6%). Pacemakers were implanted only in three patients from the SVC isolation group. The only factor influencing recurrence of ATa was LA diameter.
Conclusions:Empirical SVC isolation during thoracoscopic ablation for persistent AF did not improve patient outcomes.
