Journal: BMC Cardiovascular Disorders

Article Title: A case report of sinus node–sparing hybrid ablation for refractory sinus tachycardia following cardioneuroablation for sinus node dysfunction

doi: 10.1186/s12872-025-05255-w

Figure Lengend Snippet: A A baseline biplane high-density three-dimensional electrocanatomical endocardial activation map (Advisor HD Grid catheter and Ensite Precision, Abbott, St Paul, MN, USA) of right atrium [superior vena cava (SVC), high right atrium (HRA), low right atrium (LRA), tricuspid annulus (TA)/His area and inferior vena cava (IVC) in LAO (left panel) and RAO view (right panel)]. It was generated from femoral access to validate the baseline earliest local activation time of the sinoatrial node (SN area) during sinus rhythm of 85 bpm. B VATS view of the right atrium after opening the pericardium. Crista terminalis line creation via a bipolar isolator synergistic surgical ablation system (AtriCure, Mason, OH, USA). C Right-sided thoracoscopic view of the right atrium showing the sinus node–sparing hybrid lesion set. The illustration depicts the epicardial surface of the right atrium and caval veins from a right-sided thoracoscopic perspective. The sinus node region (yellow star) is first identified by combined endocardial activation mapping and epicardial visualization and is deliberately spared. Purple solid lines indicate the planned bipolar epicardial ablation lines: the SVC line at the right atrium–superior vena cava junction to modify/isolates SVC myocardial sleeves; the IVC line at the right atrium–inferior vena cava junction; and the crista terminalis line connecting both caval lesions along the crista terminalis to limit preferential sinus-node exit pathways. Abbreviations: RAA – right atrial appendage; SVC – superior vena cava; IVC – inferior vena cava; RSPV/RIPV – right superior/inferior pulmonary vein; PVI – pulmonary vein isolation; SN – sinus node

Article Snippet: Fig. 1 A A baseline biplane high-density three-dimensional electrocanatomical endocardial activation map (Advisor HD Grid catheter and Ensite Precision, Abbott, St Paul, MN, USA) of right atrium [superior vena cava (SVC), high right atrium (HRA), low right atrium (LRA), tricuspid annulus (TA)/His area and inferior vena cava (IVC) in LAO (left panel) and RAO view (right panel)].

Techniques: Activation Assay, Generated, Isolation