title: Left atrial-coronary sinus dissociation following an attempt at radiofrequency ablation for a left lateral accessory pathway.
abstract: Coronary sinus electrograms generally represent the sequence of left atrial activation, and are very helpful in localizing and differentiating left lateral accessory pathway-mediated tachycardia from other supraventricular tachycardias. The activation of the coronary sinus from the left atrium occurs through muscle bridges, which may be discrete or form an intermingled continuum. These muscle bridges, if disconnected, may dissociate the coronary sinus from the left atrium, in which case the coronary sinus electrograms do not represent left atrial activation, and do not help to understand, or may cause misinterpretation of, the mechanism of supraventricular tachycardia. We report one such case of orthodromic supraventricular tachycardia mediated through the left lateral accessory pathway in which the coronary sinus got dissociated from the left atrium during radiofrequency ablation.
authors.affiliation: Department of Cardiology, Batra Hospital and Medical Research Centre, New Delhi.
authors.forename: Balbir
authors.initials: B
authors.lastname: Singh
authors.forename: Rakesh
authors.initials: R
authors.lastname: Sapra
authors.forename: Ripen K
authors.initials: RK
authors.lastname: Gupta
authors.forename: Tapan
authors.initials: T
authors.lastname: Ghose
authors.forename: Rahul
authors.initials: R
authors.lastname: Trehan
authors.forename: Upendra
authors.initials: U
authors.lastname: Kaul
mesh_terms: D000328:Adult; D017115:Catheter Ablation / Q000009:adverse effects*; D003331:Coronary Vessels / Q000601:surgery; D004562:Electrocardiography; D006329:Heart Conduction System / Q000601:surgery; D006801:Humans; D008297:Male; D011226:Pre-Excitation Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013617:Tachycardia, Supraventricular / Q000628:therapy*