Role of the coronary sinus ostium musculature in reentrant formation.

Herzschrittmachertherapie & Elektrophysiologie
Y HuoC Piorkowski

Abstract

Radiofrequency ablation of focal atrial tachycardias (AT) is a validated technique with high success rates. However, electrophysiological (EP) characteristics and ablation strategy of localized reentrant AT originating from the coronary sinus ostium (CSo) have not been reported in detail so far. From January 2009 to July 2010, 1,453 patients underwent clinically motivated EP studies. Four patients were diagnosed with localized reentrant AT originating from the CSo. P wave morphology and consistency of tachycardia cycle length were studied. Subsequently, if reentry was suggested as an underlying mechanism for AT, color-coded 3-dimensional (3D) entrainment mapping was performed to localize the reentrant circuit or differentiate a localized reentrant AT from macroreentant AT, and also confirm reentry as an underlying mechanism of AT by evaluating consistency of return cycles after entrainment at multiple sites in both atria. Finally, activation mapping was performed to localize the earliest activation site. The P wave morphologies and isoelectric line between the P waves suggested most likely an AT originating from the CSo with a centrifugal activation pattern, which was confirmed by activation mapping. Consistency of return cycle...Continue Reading

References

Sep 5, 2006·Journal of the American College of Cardiology·Peter M KistlerJonathan M Kalman
Nov 4, 2006·Journal of Cardiovascular Electrophysiology·Uwais MohamedGeorge J Klein
Sep 26, 2007·Circulation·Mark D O'NeillMichel Haïssaguerre
Jun 26, 2008·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Christopher PiorkowskiGerhard Hindricks
Feb 12, 2009·Journal of Cardiovascular Electrophysiology·Pierre JaïsMichel Haïssaguerre
Mar 3, 2009·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Masahiro EsatoChristopher Piorkowski
Apr 2, 2009·Pacing and Clinical Electrophysiology : PACE·Sébastien KnechtMichel Haïssaguerre

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Citations

Nov 28, 2015·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Chung-Hsing LinShih-Ann Chen

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