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Simultaneous Epicardial and Endocardial Mapping of a Left‐Sided Posteroseptal Accessory Pathway Associated with a Large Coronary Sinus Diverticulum: Successful Ablation by Transection of the Diverticulum's Neck
Author(s) -
SAAD EDUARDO B.,
MARROUCHE NASSIR F.,
COLE CHRISTOPHER R.,
NATALE ANDREA
Publication year - 2002
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1046/j.1460-9592.2002.01524.x
Subject(s) - medicine , coronary sinus , diverticulum (mollusc) , accessory pathway , ablation , catheter , catheter ablation , cardiology , sinus (botany) , pericardial cavity , radiology , surgery , pericardium , botany , biology , genus
SAAD, E.B., et al. : Simultaneous Epicardial and Endocardial Mapping of a Left‐Sided Posteroseptal Accessory Pathway Associated with a Large Coronary Sinus Diverticulum: Successful Ablation by Tran‐section of the Diverticulum's Neck. Transcutaneous pericardial instrumentation in a patient with a left‐sided posteroseptal accessory pathway associated with a large coronary sinus diverticulum was performed after three previous unsuccessful ablations. The earliest ventricular activation site was recorded epicardially using a catheter in the pericardial space, but energy delivery at this site was not possible due to high impedances. Intravascular linear lesions transecting the neck of the large coronary sinus diverticulum using the pericardial catheter as a target allowed successful radiofrequency catheter ablation of the accessory pathway. This case outlines potential problems with ablations in the pericardial space and provides an alternative solution that can spare patients from open surgical procedures.