The value of the accessory pathway potential in ablation within coronary sinus

Abstract Background In accessory pathway-related supraventricular tachycardia ablation, coronary sinus (CS) ablation has received more and more attention, but there are no accurate criteria for catheter selection. Objectives We intended to develop a new method for the reasonable selection of electrode for coronary sinus ablation via assessing the relationship between the accessory pathway (AP) potential and time of successful ablation. Methods Among the patients who had detected the bypass potential during radiofre-quency ablation between 1/1/2015 and 12/31/2019, 30 patients underwent radiofrequency catheter ablation (RFCA) in CS. The relationship between AP potential and time of successful ablation was analyzed. Results In CS ablation, the median baseline amplitude of the AP potentials in patients with successful Temperature control catheter (TCC) ablation was higher than that in patients with Irrigated-tip catheter (ITC) following TCC ablation failure (p = 0.02). The optimal cutoff value of the amplitude of the AP potential to guide the selection of a catheter for ablation was 1.07 mV, and the sensitivity and specificity were 80% and 90%, respectively. Conclusions The AP potential is helpful for the electrode selection in CS ablation.

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The Value of The Accessory Pathway Potential in Guiding The Electrode Selection for Ablation Within Coronary Sinus

10.21203/rs.3.rs-88855/v1 ◽

2020 ◽

Author(s):

XiaoLin Sun ◽

Jiang Jiang ◽

Pei Xu ◽

Kai Jin ◽

ZhengYu Bao

Keyword(s):

Supraventricular Tachycardia ◽

Coronary Sinus ◽

Radiofrequency Catheter Ablation ◽

Accessory Pathway ◽

Optimal Cutoff ◽

Successful Ablation ◽

Selection For ◽

The Relationship ◽

Electrode Selection ◽

Selection Of

Abstract Background: The ablation of the coronary sinus (CS) is becoming more and more important in accessory pathway-related supraventricular tachycardia ablation. In comparison with temperature-controlled catheters (TCC), irrigated-tip catheter (ITC) are more expensive and cause more damage in accessory pathway-related supraventricular tachycardia ablation. We intended to develop a new method for the reasonable selection of electrode for coronary sinus(CS) ablation via assessing the relationship between the accessory pathway (AP) potential and time of successful ablation. Methods：Among the patients who had detected the bypass potential during radiofrequency ablation between 1/1/2015 and 12/31/2019. TCC was performed in 330 patients receiving endocardial ablation. 30 patients underwent radiofrequency catheter ablation (RFCA) in CS. The relationship between AP potential and time of successful ablation was analyzed. Results：330 cases of TCC ablation within the endocardium revealed that the amplitude of AP potential was significantly and negatively correlated with the time of successful ablation (r = -0.79, p < 0.001). In CS ablation, the median baseline amplitude of the AP potentials in patients with successful TCC ablation was higher than that in patients with ITC following TCC ablation failure (p = 0.02). The optimal cutoff value of the amplitude of the AP potential to guide the selection of a catheter for ablation was 1.07 mV, and the sensitivity and specificity were 80% and 90%, respectively. Conclusion：The AP potential is helpful for the electrode selection in CS ablation.

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Successful ablation of a left anterior accessory pathway from the left coronary sinus of Valsalva near the aortic–mitral continuity

Journal of International Medical Research ◽

10.1177/0300060521990249 ◽

2021 ◽

Vol 49 (3) ◽

pp. 030006052199024

Author(s):

Fan Wang ◽

Xuelian Song ◽

Yi Dang ◽

Shangzhi Shu ◽

Shuyan Li

Keyword(s):

Catheter Ablation ◽

Coronary Sinus ◽

Radiofrequency Catheter Ablation ◽

Accessory Pathway ◽

Sinus Of Valsalva ◽

Long Term Outcomes ◽

Accessory Pathways ◽

Successful Ablation

Catheter ablation of accessory pathways can be challenging depending on the location of these pathways, and accessory pathways are rare through the aortic cusps. We report a patient who underwent radiofrequency catheter ablation for manifestation of a left anterior accessory pathway from the left coronary sinus of Valsalva near the aortic–mitral continuity. Anterior accessory pathways can be safely and effectively ablated from the aortic cusps with favorable long-term outcomes.

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