Changing coronary sinus activation during catheter ablation of isthmus-dependent right atrial flutter: what is the mechanism?
A 69-year-old woman was referred for cavotricuspid isthmus ablation due to typical isthmus-dependent right atrial flutter. During ablation, intracardiac activation sequence in coronary sinus (CS) changed without altering the cycle length or the P-wave morphology. This suggests that interatrial connection via CS was blocked and left atrium (LA) was activated from Bachmann's bundle or/and connections between fossa ovalis and LA.
Silesian Centre for Heart Disease, Zabrze,  Poland.
Piotr
P
Buchta
Philipp
P
Sommer
Lech
L
Polonski
Mariusz
M
Gąsior
Gerhard
G
Hindricks
Arash
A
Arya
D000368:Aged; D001282:Atrial Flutter / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*; D017115:Catheter Ablation; D054326:Coronary Sinus / Q000000981:diagnostic imaging / Q000502:physiology*; D004562:Electrocardiography; D005260:Female; D005471:Fluoroscopy; D006325:Heart Atria / Q000503:physiopathology / Q000601:surgery; D006346:Heart Septum / Q000503:physiopathology / Q000601:surgery; D006801:Humans