High Risk Accessory Pathway Ablation Inside a Large Coronary Sinus Diverticulum in a Patient with Coexistent Drug-Induced Type 1 Brugada ECG Pattern

2013 ◽  
Vol 25 (1) ◽  
pp. 101-102 ◽  
Author(s):  
GIULIO ZUCCHELLI ◽  
MARIA GRAZIA BONGIORNI ◽  
GIOVANNI COLUCCIA ◽  
ANDREA DI CORI
Keyword(s):  
High Risk ◽  
Coronary Sinus ◽  
Accessory Pathway ◽  
Drug Induced ◽  
Coronary Sinus Diverticulum

scholarly journals Abolishment of high-risk left lateral accessory pathway by myocardial infarction: a blessing in disguise? A case report

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Jim O’Brien ◽  
Nikola Kozhuharov ◽  
Shui Hao Chin ◽  
Mark Hall
Keyword(s):  
Atrial Fibrillation ◽  
Acute Coronary Syndrome ◽  
Case Report ◽  
High Risk ◽  
Coronary Sinus ◽  
Refractory Period ◽  
Accessory Pathway ◽  
Coronary Syndrome ◽  
Electrophysiology Study ◽  
Anomalous Coronary

Abstract Background Antegradely conducting left lateral accessory pathways are a risk for supraventricular tachycardias and pre-excited atrial fibrillation. Rarely, an anomalous coronary sinus can cause difficulty in locating the pathway. The left circumflex coronary artery and obtuse marginal branches supply the posterolateral left ventricle. We describe a case report of a high-risk accessory pathway associated with an anomalous coronary sinus which, between successive electrophysiology studies, was obliterated by a felicitous acute coronary syndrome in the left circumflex territory. Case summary A 49-year-old male with palpitations and manifest pre-excitation was referred for electrophysiology study. Initial study revealed a high-risk left lateral accessory pathway with antegrade effective refractory period of 240 ms and rapidly conducting pre-excited atrial fibrillation. The coronary sinus could not be cannulated to localize the pathway. Coronary angiography and cardiac computed tomography showed an anomalous coronary sinus emptying into the right atrial free wall and patent coronaries. While awaiting repeat electrophysiology study, the patient suffered an acute coronary syndrome with immediate loss of previously visible pre-excitation on electrocardiogram, and underwent stenting of an occluded marginal branch of the circumflex. Repeat electrophysiology study demonstrated a now low-risk accessory pathway (effective refractory period 390 ms). Since infarction, the patient’s palpitations have fully settled with all subsequent electrocardiograms devoid of manifest pre-excitation. Discussion Left lateral accessory pathways, which can associate with an anomalous coronary sinus, derive from tissue similar to normal ventricular myocardium and are vulnerable to ischaemic insults in the area subtended by the circumflex artery.

scholarly journals Use of 3D mapping system for ablating an accessory pathway associated with coronary sinus diverticulum

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Mohammad Paymard ◽  
Marc W. Deyell ◽  
Santabhanu Chakrabarti ◽  
Zachary W. Laksman ◽  
Jacob Larsen ◽  
...  
Keyword(s):  
Coronary Sinus ◽  
Accessory Pathway ◽  
Three Dimensional ◽  
Radiofrequency Energy ◽  
Cardiac Mapping ◽  
Unsuccessful Attempt ◽  
White Syndrome ◽  
Mapping System ◽  
Coronary Sinus Diverticulum ◽  
Wolff Parkinson White Syndrome

Abstract Background This is a rare and challenging case of Wolff–Parkinson–White syndrome due to a posteroseptal accessory pathway located in the coronary sinus diverticulum. It is often difficult to precisely locate this type of accessory pathway, and the ablation procedure could be associated with collateral damage to the neighbouring coronary arteries. Case Presentation The patient was a 49-year-old female with Wolff–Parkinson–White syndrome who was referred for catheter ablation. She had had a previous unsuccessful attempt at ablation and had remained symptomatic despite drug therapy. The pre-procedural cardiac computed tomography scan revealed the presence of a diverticulum in the proximal coronary sinus. Using an advanced three-dimensional cardiac mapping system, the electroanatomic map of the diverticulum was created. The accessory pathway potential was identified within the diverticulum preceding the ventricular insertion. The accessory pathway was then successfully ablated using radiofrequency energy. Conclusion We have demonstrated that the advanced three-dimensional cardiac mapping system plays a very important role in guiding clinicians in order to precisely locate and safely ablate this type of challenging accessory pathway.

A 2-year-old child with coronary sinus diverticulum and Wolff–Parkinson–White syndrome

2012 ◽  
Vol 23 (2) ◽  
pp. 274-276 ◽  
Author(s):  
Haridas P. Veloor ◽  
Yash Lokhandwala
Keyword(s):  
Radiofrequency Ablation ◽  
Coronary Sinus ◽  
Accessory Pathway ◽  
White Syndrome ◽  
Electrophysiological Analysis ◽  
Coronary Sinus Diverticulum ◽  
Wolff Parkinson White Syndrome

AbstractA 2-year-old child having Wolff–Parkinson–White syndrome presented with recurrent drug-refractory tachycardia episodes. On electrophysiological analysis, a coronary sinus diverticulum was discovered. The accessory pathway was successfully eliminated by radiofrequency ablation within the diverticulum.

scholarly journals Coronary sinus diverticulum containing posteroseptal accessory pathway

Heart ◽  
2001 ◽  
Vol 86 (5) ◽  
pp. 539-539 ◽  
Author(s):  
D H BENNETT
Keyword(s):  
Coronary Sinus ◽  
Accessory Pathway ◽  
Coronary Sinus Diverticulum ◽  
Posteroseptal Accessory Pathway

Posteroseptal accessory pathway in association with coronary sinus diverticulum: electrocardiographic description and result of catheter ablation

2013 ◽  
Vol 38 (1) ◽  
pp. 43-49 ◽  
Author(s):  
Babak Payami ◽  
Akbar Shafiee ◽  
Maryam Shahrzad ◽  
Ali Kazemisaeed ◽  
Gholamreza Davoodi ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Coronary Sinus ◽  
Accessory Pathway ◽  
Coronary Sinus Diverticulum ◽  
Posteroseptal Accessory Pathway

Radiofrequency catheter ablation of a posteroseptal accessory pathway within a coronary sinus diverticulum

1993 ◽  
Vol 126 (5) ◽  
pp. 1216-1219 ◽  
Author(s):  
Jürgen Tebbenjohanns ◽  
Dietrich Pfeiffer ◽  
Werner Jung ◽  
Matthias Manz ◽  
Berndt Lüderitz
Keyword(s):  
Catheter Ablation ◽  
Coronary Sinus ◽  
Radiofrequency Catheter Ablation ◽  
Accessory Pathway ◽  
Coronary Sinus Diverticulum ◽  
Posteroseptal Accessory Pathway

Trans-subclavian Approach for Radiofrequency Ablation of Atrioventricular Accessory Pathway Associated with Coronary Sinus Diverticulum

2016 ◽  
Vol 25 (10) ◽  
pp. e145-e147 ◽  
Author(s):  
Fang-Zhou Liu ◽  
Hong-Tao Liao ◽  
Yu-Mei Xue ◽  
Xian-Zhang Zhan ◽  
Shu-Lin Wu
Keyword(s):  
Radiofrequency Ablation ◽  
Coronary Sinus ◽  
Accessory Pathway ◽  
Coronary Sinus Diverticulum

scholarly journals Successful Radiofrequency Catheter Ablation of Left Anterolateral Accessory Pathway Associated with a Coronary Sinus Diverticulum Using an Irrigated-Tip Catheter

2011 ◽  
Vol 27 (Supplement) ◽  
pp. PJ3_059
Author(s):  
Hiroko Goto ◽  
Takeshi Hirose ◽  
Atsushi Kaneko ◽  
Nobuyuki Tetsuka ◽  
Atsushi Terazawa ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Coronary Sinus ◽  
Radiofrequency Catheter Ablation ◽  
Accessory Pathway ◽  
Coronary Sinus Diverticulum

Accessory Pathway Catheter Ablation Inside the Neck of a Coronary Sinus Diverticulum

2003 ◽  
Vol 14 (12) ◽  
pp. 1386-1386 ◽  
Author(s):  
THORSTEN LEWALTER ◽  
ALEXANDER YANG ◽  
JORG O. SCHWAB ◽  
BERNDT LUDERITZ
Keyword(s):  
Catheter Ablation ◽  
Coronary Sinus ◽  
Accessory Pathway ◽  
Coronary Sinus Diverticulum
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