Antidromic and orthodromic reciprocating tachycardias over a novel left-sided accessory pathway involving the vein of Marshall and coronary sinus musculature.
J Cardiovasc Electrophysiol
; 34(11): 2398-2402, 2023 Nov.
Article
in En
| MEDLINE
| ID: mdl-37727933
INTRODUCTION: Herein, we present a rare case of the successful ablation of an accessory pathway (AP) involving the Marshall Bundle (MB) and coronary sinus musculature (CSM) in a 40-year-old man with Wolff-Parkinson-White syndrome. METHODS AND RESULTS: An orthodromic reciprocating tachycardia (ORT) was inducible with the earliest atrial activation site located at the posterolateral mitral annulus. The local conduction and the cycle length of ORT was prolonged by peri-mitral ablation; however, it failed to block the AP. The atrial insertion of the AP was identified by remapping during ORT at the left atrial ridge, which was away from the mitral annulus, where ablation was successful. Together with the electrophysiological findings in CSM potentials, we conclude that the epicardial MB-CSM connection functioned as the AP in this patient. CONCLUSION: The novel variant form of AP comprised of MB and CSM should be noted. The atrial insertion of the MB may be the target of catheter ablation.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Wolff-Parkinson-White Syndrome
/
Catheter Ablation
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Coronary Sinus
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Tachycardia, Reciprocating
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Accessory Atrioventricular Bundle
Type of study:
Prognostic_studies
Limits:
Adult
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Humans
/
Male
Language:
En
Journal:
J Cardiovasc Electrophysiol
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
/
FISIOLOGIA
Year:
2023
Document type:
Article
Affiliation country:
Japan
Country of publication:
United States