Transient sinus node dysfunction following sinus node artery occlusion due to radiofrequency catheter ablation of the septal superior vena cava–right atrium junction

• This is the first case of direct coronary angiographies in a patient with sinus node dysfunction due to sinus node artery (SNA) injury during catheter ablation (CA) for a rapid firing of atrial fibrillation from the septal superior vena cava (SVC)–right atrium (RA) junction.
• Clinically manifested injury to the coronary arteries during CA procedures for atrial arrhythmias is rare; the prevalence of SNA injury is about 0.09%.
• The direction of the SNA should be considered during CA at the septal SVC–RA junction.

We performed catheter ablation to septal superior vena cava (SVC)–right atrium (RA) junction rapid firing in a 57-year-old man with paroxysmal atrial fibrillation. He later experienced transient sinus node dysfunction resulting from injury to the sinus node artery (SNA), which branched only from the proximal region of the left circumflex artery. The direction of the SNA should be considered during catheter ablation at the septal SVC–RA junction, especially if the sinus node is supplied by only one SNA from the right coronary artery or the left circumflex artery.