ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2022
Empirical superior vena cava isolation in patients undergoing repeat catheter ablation procedure after recurrence of atrial fibrillation.
Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Usefulness of empiric superior vena cava isolation in paroxysmal atrial fibrillation ablation: a meta-analysis of randomized clinical trials.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025Pooled it
- Repeat in situ ablation vs. extensive ablation for recurrent persistent atrial fibrillation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Trial
- Role of electroanatomical mapping-guided superior vena cava isolation in paroxysmal atrial fibrillation patients without provoked superior vena cava triggers: a randomized controlled study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Trial
- Recurrence of Atrial Fibrillation After Repeat Catheter Ablation: A Systematic Review and Meta-Analysis.Acta Cardiologica Sinica · 2026Article
- Adjunctive empirical superior vena cava isolation with fourth-generation cryoballoon in paroxysmal atrial fibrillation does not improve outcomes and increases complications: the randomized CISPAF trial.Frontiers in cardiovascular medicine · 2026Article
- Outcomes after redo ablation for the recurrence of atrial fibrillation: a systematic review and meta-analysis.Clinical research in cardiology : official journal of the German Cardiac Society · 2025Article
- Prospective evaluation of low voltage-guided repeat ablation of atrial fibrillation.Clinical research in cardiology : official journal of the German Cardiac Society · 2025Article
- The impact of empirical superior vena cava isolation in addition to pulmonary vein isolation on outcomes in atrial fibrillation - Systematic review, meta-analysis, and meta-regression.International journal of cardiology. Heart & vasculature · 2025Article
- Translational Anatomy of the Sinoatrial Node: Myoarchitecture and its Relevance for Catheter Ablation: Part II: Clinical Applications.JACC. Case reports · 2025Article
- Atrial Fibrillation and Underlying Structural and Electrophysiological Heterogeneity.International journal of molecular sciences · 2024Review
- Repeat ablation of atrial fibrillation using electrogram dispersion to identify additional areas of mechanistic significance.Heart rhythm O2 · 2024Article
- Long-term Outcomes of Cryoballoon-based Empirical Superior Vena Cava Isolation in Addition to Pulmonary Vein Isolation in Persistent Atrial Fibrillation.Anatolian journal of cardiology · 2024Article
- High-Power Short-Duration Ablation of Paroxysmal and Persistent Atrial Fibrillation.Reviews in cardiovascular medicine · 2023Review
- Hybrid atrial fibrillation ablation: long-term outcomes from a single-centre 10-year experience.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
- Efficacy, Safety and Feasibility of Superior Vena Cava Isolation in Patients Undergoing Atrial Fibrillation Catheter Ablation: An Up-to-Date Review.Biomedicines · 2023Review
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough the ectopic foci responsible for initiating atrial fibrillation (AF) are usually located in the pulmonary veins (PVs), non-PV sources may initiate AF in approximately 11% of unselected patients with paroxysmal or persistent AF. The superior vena cava (SVC) is one of the most frequent non-PV origins for initiating AF. This study aims to investigate the effect of empirical SVC isolation in redo AF ablation procedures.
methodsConsecutive patients undergoing redo AF ablation procedures using a high-power short-duration protocol (HPSD) (50 W; ablation index guided; target AI 350 for posterior wall ablation, AI 450 for anterior wall ablation; CARTO 3 mapping system) were included. Patients with SVC isolation were compared to patients without SVC isolation. Periprocedural parameters and complications were recorded and analyzed. Short-term endpoints included intrahospital AF recurrence, midterm endpoint AF freedom after 3 months, and long-term endpoint AF freedom after 12 months.
resultsA total of 276 patients underwent repeat ablation for recurrent AF (67 ± 10 years; 57% male; 31.5% paroxysmal AF). The patients were divided into two groups: redo procedures with SVC isolation vs redo procedure without SVC isolation. Additional LA substrate modification was done based on intraprocedural voltage maps. Baseline characteristics did not differ significantly between the two groups. Median procedure time was 85.4 ± 27.1 min with ablation times of 14.0 ± 8.5 min. Intrahospital AF recurrence occurred in 32 patients (12%) with no difference among both groups: 17 patients (13%) SVC vs 15 patients (10%) No-SVC; p = 0.416. At 3-month follow-up, 47 (17%) presented an AF recurrence during the blanking period: 25 patients (19%) SVC vs 22 patients (15%) No-SVC; p = 0.304). After 12 months, 202 (73%) of all patients were in stable sinus rhythm with no significant difference between the two groups: 93 patients (73%) SVC vs 109 patients (74%) No-SVC; p = 0.853). No significant differences were noted when dividing the patients in paroxysmal or persistent AF with and without SVC isolation.
conclusionsIn our series of repeat AF ablation procedures, the addition of empirical SVC isolation to Re-PVI and LA substrate modification did not influence AF recurrence rates. This strategy can however be safe and useful in patients in whom SVC is identified as a trigger of AF.
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