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Atrial Arrhythmia Ablation in Adult Congenital Heart Disease with a Persistent Left-side Superior Vena Cava

Shinya Yamada1,2, Li-Wei Lo1,3, Yenn-Jiang Lin1,3

  • 1Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan.

Internal Medicine (Tokyo, Japan)
|September 20, 2017
PubMed

Insights

We report a case of atrial tachycardia from a dilated coronary sinus in a patient with a persistent left superior vena cava. An ultra-rapid high-density mapping system successfully identified and ablated the tachycardia source.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Congenital Heart Disease

Background:

  • Atrial tachycardia (AT) can be challenging to manage, especially in patients with complex congenital heart disease.
  • Persistent left superior vena cava is a rare congenital anomaly that can complicate cardiac procedures.

Observation:

  • A case of atrial tachycardia originating from a dilated coronary sinus connected to a persistent left superior vena cava is presented.
  • The earliest activation site was precisely localized to the superior coronary sinus ostium.

Findings:

  • A novel ultra-rapid high-density mapping system (Rhythmia™) was utilized for precise localization of the arrhythmogenic focus.
  • Successful radiofrequency ablation was performed at the identified superior coronary sinus ostium.

Implications:

  • This case highlights the diagnostic and therapeutic utility of advanced mapping systems in complex electrophysiological cases.
  • Ultra-rapid high-density mapping offers a valuable tool for identifying and treating atrial tachycardia in adults with congenital heart disease.

Keywords:
adult congenital heart diseaseatrial tachycardiadilated coronary sinusultra-rapid high-density mapping

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