Elucidating left atrial electrical potential with microelectrode catheter: A case of coronary sinus ostial atresia with small persistent left superior vena cava.
Kohki KimuraTakeshi HaritaTetsuya HarunaPublished in: Pacing and clinical electrophysiology : PACE (2024)
A 51-year-old woman presented with recurring palpitations. Electrocardiography revealed narrow QRS tachycardia with short RP configuration. Computed tomography showed coronary sinus (CS) ostial atresia along with a small persistent left superior vena cava (PLSVC). Electrophysiological study identified the retrograde earliest atrial activation site (EAAS) at the CS ostium without decremental properties, and para-Hisian pacing suggested retrograde atrioventricular nodal conduction. Using a 1.6-Fr microelectrode catheter distally placed in the CS via the PLSVC, EAAS was confirmed within the left atrium, not the CS ostium. Transseptal approach revealed a left lateral accessory pathway, which was successfully eliminated.
Keyphrases
- vena cava
- left atrial
- catheter ablation
- inferior vena cava
- atrial fibrillation
- computed tomography
- coronary artery disease
- coronary artery
- mitral valve
- left ventricular
- single cell
- cardiac resynchronization therapy
- deep brain stimulation
- heart failure
- lymph node
- pulmonary embolism
- squamous cell carcinoma
- pulmonary artery
- magnetic resonance
- transcatheter aortic valve replacement
- human health
- aortic valve
- pulmonary hypertension
- dual energy