A new method of superior vena cava isolation without phrenic nerve
injury by longitudinal ablation parallel to the phrenic nerve: A case
report
Abstract
Superior vena cava (SVC) isolation improves outcomes in patients with
atrial fibrillation (AF). However, right phrenic nerve (PN) injury is a
major complication of this procedure. Repeated SVC isolation was
performed due to recurrence of SVC-triggered AF. The right atrium
(RA)-SVC activation map revealed that the propagation broke through the
gap at the PN site from the RA to the SVC. To avoid PN injury, the SVC
was isolated by making longitudinal lines on both sides of the PN in a
cranial direction. This novel approach of SVC isolation may be an
effective therapeutic option to prevent PN injury.