Remaining challenges in catheter ablation of accessory pathways: rare entity of coronary sinus diverticulum-associated pathways View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-04

AUTHORS

Patrick Leitz, K. Wasmer, J. Köbe, D. G. Dechering, G. Frommeyer, F. Güner, C. Ellermann, F. Reinke, L. Eckardt

ABSTRACT

INTRODUCTION: A limited number of case reports of coronary sinus (CS) diverticula complicating catheter ablation have been published. METHODS AND RESULTS: We retrospectively analysed 2245 patients who underwent ablation of an accessory pathway (AP) at our institution between 1/11/1993 and 31/10/2016. Eight patients (0.36%) were found to have a CS diverticulum in venography. APs showed a mean antegrade conduction time of 276 ± 23 ms (range 220-310 ms) and a mean retrograde conduction of 301 ± 45 ms (230-350 ms). Four patients had 1 (n = 2), 2 (n = 1), or 3 (n = 1) previously failed ablation attempts. Pathways could not be ablated with a conventional 4 mm tip catheter in 7 of 8 cases. In seven patients, ablation was successful, in two using an 8-mm ablation catheter, in two using cryoablation, and in the remaining three with an irrigated tip ablation catheter. After failed femoral approach, one 9-year-old female was successfully ablated via the right jugular vein. In one 75-year-old female, ablation was not successful. During a mean follow-up of 8.9 ± 6.4 years, all patients remained free of recurrences. CONCLUSION: In inferoseptal pathways, especially with previous failed ablation attempts, venographies of the CS should be performed. After successful ablation long-term prognosis is excellent. More... »

PAGES

388-394

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00392-018-1367-3

DOI

http://dx.doi.org/10.1007/s00392-018-1367-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1106615331

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30182165


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