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Use of 3D mapping system for ablating an accessory pathway associated with coronary sinus diverticulum Paymard, Mohammad; Deyell, Marc W.; Chakrabarti, Santabhanu; Laksman, Zachary; Larsen, Jacob; Yeung-Lai-Wah, John A.

Abstract

Background This is a rare and challenging case of Wolff–Parkinson–White syndrome due to a posteroseptal accessory pathway located in the coronary sinus diverticulum. It is often difficult to precisely locate this type of accessory pathway, and the ablation procedure could be associated with collateral damage to the neighbouring coronary arteries. Case Presentation The patient was a 49-year-old female with Wolff–Parkinson–White syndrome who was referred for catheter ablation. She had had a previous unsuccessful attempt at ablation and had remained symptomatic despite drug therapy. The pre-procedural cardiac computed tomography scan revealed the presence of a diverticulum in the proximal coronary sinus. Using an advanced three-dimensional cardiac mapping system, the electroanatomic map of the diverticulum was created. The accessory pathway potential was identified within the diverticulum preceding the ventricular insertion. The accessory pathway was then successfully ablated using radiofrequency energy. Conclusion We have demonstrated that the advanced three-dimensional cardiac mapping system plays a very important role in guiding clinicians in order to precisely locate and safely ablate this type of challenging accessory pathway.

Item Metadata

Title
Use of 3D mapping system for ablating an accessory pathway associated with coronary sinus diverticulum
Creator
Paymard, Mohammad; Deyell, Marc W.; Chakrabarti, Santabhanu; Laksman, Zachary; Larsen, Jacob; Yeung-Lai-Wah, John A.
Contributor
University of British Columbia. UBC Division of Cardiology & Cardiovascular Surgery
Publisher
BioMed Central
Date Issued
2021-05-27
Description
Background This is a rare and challenging case of Wolff–Parkinson–White syndrome due to a posteroseptal accessory pathway located in the coronary sinus diverticulum. It is often difficult to precisely locate this type of accessory pathway, and the ablation procedure could be associated with collateral damage to the neighbouring coronary arteries. Case Presentation The patient was a 49-year-old female with Wolff–Parkinson–White syndrome who was referred for catheter ablation. She had had a previous unsuccessful attempt at ablation and had remained symptomatic despite drug therapy. The pre-procedural cardiac computed tomography scan revealed the presence of a diverticulum in the proximal coronary sinus. Using an advanced three-dimensional cardiac mapping system, the electroanatomic map of the diverticulum was created. The accessory pathway potential was identified within the diverticulum preceding the ventricular insertion. The accessory pathway was then successfully ablated using radiofrequency energy. Conclusion We have demonstrated that the advanced three-dimensional cardiac mapping system plays a very important role in guiding clinicians in order to precisely locate and safely ablate this type of challenging accessory pathway.
Subject
Coronary sinus diverticulum; Posteroseptal accessory pathway; Supraventricular tachycardia; Wolff–Parkinson–White syndrome; Three-dimensional cardiac mapping; Catheter ablation
Genre
Article
Type
Text
Language
eng
Date Available
2021-06-28
Provider
Vancouver : University of British Columbia Library
Rights
Attribution 4.0 International (CC BY 4.0)
DOI
10.14288/1.0398711
URI
http://hdl.handle.net/2429/78820
Affiliation
Medicine, Faculty of; Cardiology, Division of
Citation
International Journal of Arrhythmia. 2021 May 27;22(1):8
Publisher DOI
10.1186/s42444-021-00037-9
Peer Review Status
Reviewed
Scholarly Level
Faculty
Copyright Holder
The Author(s)
Rights URI
http://creativecommons.org/licenses/by/4.0/
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Attribution 4.0 International (CC BY 4.0)