Left atrial-coronary sinus dissociation following an attempt at radiofrequency ablation for a left lateral accessory pathway
Singh, B.; Sapra, R.; Gupta, R.K.; Ghose, T.; Trehan, R.; Kaul, U.
Indian Heart Journal 55(4): 376-378
2003
ISSN/ISBN: 0019-4832 PMID: 14686672 Document Number: 560535
Coronary sinus electrograms generally represent the sequence of left atrial activation, and are very helpful in localizing and differentiating left lateral accessory pathway-mediated tachycardia from other supraventricular tachycardias. The activation of the coronary sinus from the left atrium occurs through muscle bridges, which may be discrete or form an intermingled continuum. These muscle bridges, if disconnected, may dissociate the coronary sinus from the left atrium, in which case the coronary sinus electrograms do not represent left atrial activation, and do not help to understand, or may cause misinterpretation of, the mechanism of supraventricular tachycardia. We report one such case of orthodromic supraventricular tachycardia mediated through the left lateral accessory pathway in which the coronary sinus got dissociated from the left atrium during radiofrequency ablation.