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A new method of superior vena cava isolation without phrenic nerve injury by longitudinal ablation parallel to the phrenic nerve: A case report
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  • Tomoyuki Arai,
  • Rintaro Hojo,
  • Koichiro Yamaoka,
  • Sayuri Tokioka,
  • Takashi Kimura,
  • Masao Takahashi,
  • Takeshi Kitamura,
  • Seiji Fukamizu
Tomoyuki Arai
Tokyo Metropolitan Hiroo Hospital

Corresponding Author:[email protected]

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Rintaro Hojo
Tokyo Metropolitan Hiroo Hospital
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Koichiro Yamaoka
Tokyo Metropolitan Hiroo Hospital
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Sayuri Tokioka
Tokyo Metropolitan Hiroo Hospital
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Takashi Kimura
Tokyo Metropolitan Hiroo Hospital
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Masao Takahashi
University f Occupational and Enviornmental Health, Japan
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Takeshi Kitamura
Tokyo Metropolitan Hiroo Hospital
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Seiji Fukamizu
Tokyo Metropolitan Hiroo Hospital
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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.