A case of accessory pathway between the coronary sinus musculature and the left ventricle. Issue 5 (6th September 2019)

• Record Type: Journal Article
• Authors: Takenaka, Sou; Suzuki, Jun; Ueno, Akihiko; Uchiyama, Takashi
• Is Part Of: Journal of arrhythmia. Volume 35:Issue 5(2019)
• Page Start: 748
• Page End: 751
• Publication Date: 2019-09-06
• Subjects: ablation -- accessory pathway -- coronary sinus musculature; Arrhythmia -- Periodicals; Cardiac pacing -- Periodicals; Arrhythmias, Cardiac; Arrhythmia; Cardiac pacing; Periodicals; Electronic journals; Periodicals; 616.128
• DOI: 10.1002/joa3.12235
• Languages: English
• ISSNs: 1880-4276

Abstract

Abstract: A 64‐year‐old female underwent catheter ablation of long R‐P' tachycardia. Ventricular pacing exhibited retrograde conduction with an identical atrial activation sequence as during tachycardia because of an accessory pathway (AP) with a long VA conduction. A radiofrequency application within the posterior coronary sinus (CS) could achieve a change of activation pattern from distal‐to‐proximal to proximal‐to‐distal within CS proximal to the ablation site, caused by conduction block of CS musculature (CSM) at the proximal site. This phenomenon could explain that this AP was connected between the CSM and the left ventricle, in site far away from the discrete connection between the left atrium and CSM. Abstract : After application energy in the coronary sinus (CS), the activation sequence of the CS proximal to the ablation site changed from distal‐to‐proximal to proximal‐to‐distal during application, caused by the conduction block of CS musculature at the proximal site. This phenomenon could explain that the accessory pathway was connected directly to CS musculature in site far away from the discrete connection between the LA and CS musculature.