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- Title
Structural characteristics of patients with superior vena cava foci initiating atrial fibrillation: Analysis with electrocardiogram‐triggered computed tomography.
- Authors
Oka, Satoshi; Yamagata, Kenichiro; Nishii, Tatsuya; Tonegawa‐Kuji, Reina; Shimamoto, Keiko; Inoue, Yuko; Miyamoto, Koji; Nagase, Satoshi; Aiba, Takeshi; Kusano, Kengo
- Abstract
Introduction: The superior vena cava (SVC) is the most common source of non‐pulmonary vein foci in atrial fibrillation (AF); therefore, predicting the existence of non‐pulmonary vein foci before the catheter ablation procedure helps construct a proper ablation strategy in preparation for SVC isolation. This study aimed to clarify the structural characteristics of patients with SVC foci initiating AF. Methods: We enrolled 331 consecutive patients with AF who underwent cardiac computed tomography imaging before radiofrequency catheter ablation treatment, and they were divided into SVC (+) and (−) groups based on the presence or absence of SVC foci initiating AF. Results: The SVC (+) group (n = 27) exhibited SVC crescent signs—defined as a curve‐shaped SVC with two narrow pointed ends—more frequently (37% vs. 9%, p <.001), and larger right atrial volume (95.6 ± 20.8 vs. 80.5 ± 26.1 mL, p =.004) than the SVC (−) group (n = 304). Multivariate logistic regression analysis revealed that the SVC crescent sign (odds ratio, 8.88; 95% confidence interval [CI], 3.21–24.60) and right atrial volume (odds ratio, 1.03; 95% CI, 1.01–1.04) were independent predictors of SVC foci. Conclusion: Patients with SVC foci exhibited more frequent SVC crescent signs and larger right atrial volumes, and these characteristics may help clinicians choose the appropriate ablation technology.
- Subjects
VENA cava superior; CONFIDENCE intervals; RADIO frequency therapy; MULTIPLE regression analysis; MULTIVARIATE analysis; ATRIAL fibrillation; CATHETER ablation; MANN Whitney U Test; ELECTROCARDIOGRAPHY; DESCRIPTIVE statistics; ODDS ratio; RECEIVER operating characteristic curves; DATA analysis software
- Publication
Journal of Cardiovascular Electrophysiology, 2023, Vol 34, Issue 3, p556
- ISSN
1045-3873
- Publication type
Article
- DOI
10.1111/jce.15825