摘要
OBJECTIVES: The goal of this study was to describe the prevalence and ablation of coronary sinus(CS) arrhythmias after left atrial ablation for atrial fibrillation(AF). OBJECTIVES: The CS has been implicated in a variety of supraventricular arrhythmias. METHODS: Thirty-eight patients underwent mapping and ablation of atypical flutter that developed during(n=5) or after(n=33) ablation for AF. Also included were two patients with focal CS arrhythmias that occurred during an AF ablation procedure. A tachycardia was considered to be originating from the CS if the post-pacing interval in the CS matched the tachycardia cycle length and/or if it terminated during ablation in the CS. RESULTS: Among the 33 patients who developed atypical flutter late after AF ablation, 9(27%) were found to have a CS origin. Overall, 16 of the 40 patients in this study had a CS arrhythmia. The tachycardia was macro-re-entrant in 14 patients(88%) and focal in two patients. Radiofrequency ablation with an 8-mm-tip catheter was successful in 15 patients(94%) without complication. In eight patients(50%),< 45 W was required for successful ablation. Thirteen of the 15 patients(87%) with a successful ablation acutely remained arrhythmia free during 5±5 months of follow-up. CONCLUSIONS: The musculature of the CS serves as a critical component of the re-entry circuit in approximately 25%of patients with atypical flutter after ablation for AF. The CS may also generate focal atrial arrhythmias that may play a role in triggering and/or maintaining AF. Catheter ablation of these arrhythmias in the CS can be performed safely.
OBJECTIVES: The goal of this study was to describe the prevalence and ablation of coronary sinus(CS) arrhythmias after left atrial ablation for atrial fibrillation(AF). OBJECTIVES: The CS has been implicated in a variety of supraventricular arrhythmias. METHODS: Thirty-eight patients underwent mapping and ablation of atypical flutter that developed during(n=5) or after(n=33) ablation for AF. Also included were two patients with focal CS arrhythmias that occurred during an AF ablation procedure. A tachycardia was considered to be originating from the CS if the post-pacing interval in the CS matched the tachycardia cycle length and/or if it terminated during ablation in the CS. RESULTS: Among the 33 patients who developed atypical flutter late after AF ablation, 9(27%) were found to have a CS origin. Overall, 16 of the 40 patients in this study had a CS arrhythmia. The tachycardia was macro-re-entrant in 14 patients(88%) and focal in two patients. Radiofrequency ablation with an 8-mm-tip catheter was successful in 15 patients(94%) without complication. In eight patients(50%),< 45 W was required for successful ablation. Thirteen of the 15 patients(87%) with a successful ablation acutely remained arrhythmia free during 5±5 months of follow-up. CONCLUSIONS: The musculature of the CS serves as a critical component of the re-entry circuit in approximately 25%of patients with atypical flutter after ablation for AF. The CS may also generate focal atrial arrhythmias that may play a role in triggering and/or maintaining AF. Catheter ablation of these arrhythmias in the CS can be performed safely.
