Radiofrequency catheter ablation of a concealed atrioventricular accessory pathway associated with a coronary sinus diverticulum.
A 31-year-old woman underwent radiofrequency catheter ablation of a concealed left posteroseptal accessory pathway associated with a coronary sinus diverticulum. The patient had previously undergone unsuccessful catheter ablation of the posteroseptal region of the mitral annulus. Coronary sinus venography revealed the presence of the diverticulum near the ostium. An electrogram in the neck of the diverticulum showed the shortest ventriculoatrial conduction time and a large accessory pathway potential during atrioventricular reciprocating tachycardia. The pathway was successfully ablated within the neck of the diverticulum. The findings in this case underscore the importance of coronary sinus venography before ablation.
Matsuo
K
K
Third Department of Internal Medicine, Nagasaki University School of Medicine, Japan. matsuok@net.nagasaki-u.ac.jp
Doi
Y
Y
Fukae
S
S
Nakao
K
K
Iliev
I
I
Komiya
N
N
Isomoto
S
S
Hayano
M
M
Yano
K
K
D000328:Adult; D001283:Atrioventricular Node / Q000502:physiology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D003330:Coronary Vessel Anomalies / Q000150:complications / Q000601:surgery*; D004240:Diverticulum / Q000150:complications / Q000601:surgery*; D005260:Female; D006329:Heart Conduction System / Q000502:physiology; D006801:Humans; D013617:Tachycardia, Supraventricular / Q000209:etiology / Q000601:surgery