Introduction
The superior vena cava (SVC) isolation has improved outcomes of paroxysmal AF originating from the SVC1,2. However, right phrenic nerve (PN) injury is one of the major complications associated with the SVC isolation procedure, and 13% of the SVC isolation procedures could not be performed because of the risk of injury to the PN1. The PN passes through the posterolateral aspect of the SVC and the right atrium (RA). Therefore, in cases where the RA-SVC conduction site is near the PN, tremendous care is required to prevent PN injury.
Here, we report a novel method of SVC isolation without PN injury by longitudinal ablation parallel to the PN in a cranial direction in cases where the PN is located on the ablation site.