In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to EHRA Ivory (& above) Members, Fellows of the ESC and Young combined Members

Superior vena cava mapping and electrical isolation using a novel ultra-high resolution 3-dimensional mapping system

Session Poster session 3

Speaker Shinsuke Miyazaki

Congress : EHRA 2019

  • Topic : arrhythmias and device therapy
  • Sub-topic : Rhythm Control, Catheter Ablation
  • Session type : Poster Session
  • FP Number : P1437

Authors : S Miyazaki (Fukui,JP), K Hasegawa (Fukui,JP), T Watanabe (Tsuchiura,JP), T Kajiyama (Tsuchiura,JP), Y Iesaka (Tsuchiura,JP), H Tada (Fukui,JP)


S Miyazaki1 , K Hasegawa1 , T Watanabe2 , T Kajiyama2 , Y Iesaka2 , H Tada1 , 1Fukui University Hospital, Department of Cardiovascular medicine - Fukui - Japan , 2Tsuchiura Kyodo Hospital - Tsuchiura - Japan ,


Background: A few studies have examined the morphological characteristics of atrial myocardial extensions into human the superior vena cava (SVC) using autopsied hearts.

Objective: This study investigated the SVC sleeve length, activation pattern during sinus rhythm, and length of isolated SVC sleeves by SVC isolations using an ultra-high resolution mapping system.

Methods: Twenty-three patients with atrial fibrillation underwent SVC mapping using a novel mini-basket catheter with 64 electrodes(0.8mm diameter, 2.5mm spacing) and automatic electrogram annotation (left panels in Figure). After SVC mapping, the isolation was performed with irrigation-tip catheters in 18(78.3%) patients followed by repeated SVC mapping (right panels in Figure).

Results: Ultra-high resolution SVC maps were successfully created in all. The median acquisition time was 7.5[5.5-9.7]mins, and 2268[1467-3347] data points were automatically annotated. The SVC sleeve length was asymmetric, and longest at the septal SVC (28.4[19.1-34.1]mm) and shortest at the antero-lateral SVC (20.0[6.3-29.9]mm). Electrical SVC isolation was successfully achieved in all 18 patients without any complications. The total number of radiofrequency applications, radiofrequency duration, and procedure time were 11.7±5.9, 4.1±2.2mins, and 9.9±8.9mins, respectively. Conduction block pre-existed at the SVC-right atrial junction prior to ablation in 3(13.0%) patients. SVC isolation was achieved without any applications at the lateral SVC in 4(22.2%) patients. The isolation line was a median of 20[13.9-29.0] mm apart from earliest activation sites during sinus rhythm. The isolated SVC sleeve length was also longest at the septal SVC(19.1[11.8-24.2]mm) and shortest at the antero-lateral SVC(6.4[0-11.3]mm)

Conclusions: Ultra-high resolution human SVC mapping demonstrated asymmetric SVC musculature sleeves. The sleeve length and activation pattern vary among individual patients.

Based on your interests

Three reasons why you should become a member

Become a member now
  • 1Access your congress resources all year-round on the New ESC 365
  • 2Get a discount on your next congress registration
  • 3Continue your professional development with free access to educational tools
Become a member now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are