Swallowing-induced atrial tachycardia arising from superior vena cava: Significant involvement of parasympathetic nerve activity Koji Higuchi, MD, PhD,

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Volume 12, Issue 5, Pages (May 2015)

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Presentation transcript:

Swallowing-induced atrial tachycardia arising from superior vena cava: Significant involvement of parasympathetic nerve activity Koji Higuchi, MD, PhD, Kenzo Hirao, MD, PhD, FHRS, Hitoshi Hachiya, MD, PhD, Mitsuaki Isobe, MD, PhD HeartRhythm Case Reports Volume 2, Issue 4, Pages 306-309 (July 2016) DOI: 10.1016/j.hrcr.2016.03.003 Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 1 Intracardiac electrocardiogram during sinus rhythm and atrial premature contractions (APCs) after swallowing and catheter locations. The earliest activation site of sinus rhythm was superior vena cava (SVC) 4 (SVC–right atrium junction), while the earliest activation site of APCs was SVC1–2, which was in the SVC. LAO = left anterior oblique; LSPV = left superior pulmonary vein; RSPV = right superior pulmonary vein; CS = coronary sinus; AP = anteroposterior. HeartRhythm Case Reports 2016 2, 306-309DOI: (10.1016/j.hrcr.2016.03.003) Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 2 High-frequency (HF) components and low-frequency (LF)/HF ratio of patient’s heart rate variability (HRV) evaluated during procedure. A-1: Preablation during procedure; A-2: postablation during procedure. B-1: Preablation from 24-hour Holter monitor; B-2: 1 day after ablation from 24-hour Holter monitor. APC = atrial premature contraction. HeartRhythm Case Reports 2016 2, 306-309DOI: (10.1016/j.hrcr.2016.03.003) Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 3 Intracardiac electrocardiogram at the successful ablation site and catheter locations. The earliest activation site of atrial premature contractions (APCs) was the posteroseptal aspect of the superior vena cava (SVC) and the local activation at the site recorded from the ablation catheter (ABL) preceded the onset of the P wave of APCs by 38 ms. APCs recorded from the unipolar lead of the ablation catheter showed QS morphology at the site. AP = anteroposterior; CS = coronary sinus; LAO = left anterior oblique. HeartRhythm Case Reports 2016 2, 306-309DOI: (10.1016/j.hrcr.2016.03.003) Copyright © 2016 Heart Rhythm Society Terms and Conditions