Nov 17, 1998

Specific electrocardiographic features of manifest coronary vein posteroseptal accessory pathways

Journal of Cardiovascular Electrophysiology
A TakahashiM Haissaguerre


Some posteroseptal accessory pathways (APs) can be successfully ablated by radiofrequency current only from inside the coronary sinus (CS) or its branches, because of an absolute or relatively epicardial location. The aim of this study was to identify ECG features of manifest posteroseptal APs requiring ablation in the CS or the middle cardiac veins (MCVs). One hundred seventeen consecutive patients with manifest posteroseptal APs successfully ablated: (1) > or = 1 cm deep inside the MCV (group MCV: n = 13); (2) inside the CS, including the area adjacent to the MCV ostium (group CS: n = 10); (3) at the right (group R: n = 60); or (4) the left posteroseptal endocardial region (group L: n = 34) were included. We reviewed delta wave polarity (initial 40 msec) and QRS morphology during sinus rhythm and atrial pacing as well as electrogram characteristics in these patients. The local target site electrogram in groups MCV and CS was characterized by a longer atrial to ventricular electrogram interval, suggesting a longer course of the pathway and more frequent recording of a presumptive AP potential compared to the group ablated at the right or left endocardium. The most sensitive ECG feature for group CS or group MCV was a negative ...Continue Reading

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Mentioned in this Paper

Biochemical Pathway
Coronary Sinus Structure
Accessory Atrioventricular Bundle
Science of Morphology
Sinus - General Anatomical Term
Endocardium Specimen
Sinus Node Artery
Cardiac Conduction System

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