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The Coronary Sinus as a Focal Source of Paroxysmal Atrial Fibrillation: More Evidence for the ‘Fifth Pulmonary Vein’?
Author(s) -
ROSTOCK THOMAS,
LUTOMSKY BORIS,
STEVEN DANIEL,
WILLEMS STEPHAN
Publication year - 2007
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 - 10.1111/j.1540-8159.2007.00805.x
Subject(s) - medicine , coronary sinus , cardiology , pulmonary vein , atrial fibrillation , paroxysmal atrial fibrillation , sinus rhythm , ablation
The coronary sinus (CS) has been described as a substrate being involved in the atrial fibrillation (AF) process. However, there are no data describing the CS as a single source of AF. We report a patient with paroxysmal AF who demonstrated an arrhythmogenic focus within the proximal CS as single source initiating and driving AF. This discrete spot was characterized by a sharp “pulmonary vein‐like” spike potential preceding every beat during AF and following the atrial potential during sinus rhythm. Radiofrequency ablation at that site led to elimination of the spike potential, disappearance and noninducibility of AF.