Absence of left atrium-coronary sinus musculature electrical connection at coronary sinus ostium unmasked by unique double coronary sinus potentials pattern.
We describe a 77-year-old man with Wolff-Parkinson-White syndrome exhibiting double coronary sinus (CS) potentials during retrograde conduction over accessory pathway (AP). The first, low-frequency potential (DP1) was first recorded in the left posterolateral region, while the second, higher frequency signal (DP2) was recorded in a lateral-to-septal direction. The two signals were fused near the left lateral wall. Successful ablation of the AP was obtained at its ventricular insertion site in the postero-septal region. The unexpectedly delayed activation of the paraseptal RA following activation of the paraseptal left atrium (DP1) can be explained by the absence of a LA-CS musculature (CSM) electrical connection at the proximal CS, which forces a detour of the activation wavefront from LA to RA via the distal CS (DP2). This is a rare case exhibiting unique double CS potentials which unmasked the absence of a LA-CSM electrical connection at CS ostium.
Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, Gunma, Japan.
Akihiro
A
Saito
Yoshiaki
Y
Kaneko
Tadashi
T
Nakajima
Tadanobu
T
Irie
Masaki
M
Ota
Toshimitsu
T
Kato
Takafumi
T
Iijima
Mio
M
Tamura
Hiroaki
H
Kobayashi
Masahiko
M
Kurabayashi
D000368:Aged; D054326:Coronary Sinus / Q000002:abnormalities* / Q000503:physiopathology; D004562:Electrocardiography / Q000379:methods; D006325:Heart Atria / Q000002:abnormalities* / Q000503:physiopathology; D006329:Heart Conduction System / Q000002:abnormalities* / Q000503:physiopathology; D006801:Humans; D008297:Male; D014927:Wolff-Parkinson-White Syndrome / Q000503:physiopathology