JACC. Case reports · 2026
Pulsed Field Ablation of Persistent Left Superior Vena Cava in an Athlete With Atrial Fibrillation.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Mi Jiaqi, Katapadi Aashish, Lakkireddy Dhanunjaya, Pothineni Naga Venkata K, Darden Douglas
Аннотация
BACKGROUND: Masters endurance athletes have an elevated risk of atrial fibrillation (AF) due to atrial remodeling, autonomic shifts, and long-term training loads. Management is challenging when persistent AF limits performance despite guideline-directed care.
CASE SUMMARY: A 60-year-old lifelong swimmer and cyclist with persistent AF experienced a 20% to 25% decline in exercise performance. AF recurred shortly after pulmonary vein isolation, and antiarrhythmic drugs were ineffective or poorly tolerated. A known persistent left superior vena cava (PLSVC) suggested a non-pulmonary vein trigger. Repeat ablation with pulsed field ablation successfully isolated the PLSVC without complications. Follow-up demonstrated restored exercise capacity and no sustained AF recurrence.
DISCUSSION: This case highlights the role of non-pulmonary vein triggers in athletes and the potential safety advantages of pulsed field ablation for complex anatomical targets.
TAKE-HOME MESSAGE: Pulsed field ablation may safely isolate arrhythmogenic PLSVC and restore performance in endurance athletes.
CASE SUMMARY: A 60-year-old lifelong swimmer and cyclist with persistent AF experienced a 20% to 25% decline in exercise performance. AF recurred shortly after pulmonary vein isolation, and antiarrhythmic drugs were ineffective or poorly tolerated. A known persistent left superior vena cava (PLSVC) suggested a non-pulmonary vein trigger. Repeat ablation with pulsed field ablation successfully isolated the PLSVC without complications. Follow-up demonstrated restored exercise capacity and no sustained AF recurrence.
DISCUSSION: This case highlights the role of non-pulmonary vein triggers in athletes and the potential safety advantages of pulsed field ablation for complex anatomical targets.
TAKE-HOME MESSAGE: Pulsed field ablation may safely isolate arrhythmogenic PLSVC and restore performance in endurance athletes.