Successful ablation of anomalous posteroseptal accessory pathway associated to coronary sinus diverticulum.
ATILIO ABUD, CRISTIAN PANTALEY, LUDMILA MELO, MARIO BARRETTO, GONZALO GASTALDI, LEANDRO TOMAS Cardiología Grupo San Gerónimo; Hospital José María Cullen. (3000) Santa Fe, Argentina
Recibido 19-NOV-2018 – ACEPTADO después de revisión el 05-ENE-2019. There are no conflicts of interest to disclose.
Coronary sinus diverticulum is a congenital anomaly that is found in 7-11% of patients carriers of posteroseptal accessory pathway. We report the case of a 40-year-old woman admitted into our service with an episode of atrial fibrillation with severe hemodynamic compromise. After successful electrical cardioversion, 12-lead electrocardiogram showed the presence of posteroseptal accessory pathway. After failed attempt of endocardial ablation by retrograde aortic access, a second approach was tried directly through the coronary sinus access. Venography revealed the presence of a large diverticulum near the ostium and the accessory pathway was ablated successfully in the neck of it, where electrogram with continuous electrical activity was recorded, presenting a potential expressing the myocardial extension within the coronary sinus. Key words: Epicardial accessory pathway. Coronary sinus diverticulum, Wolff-ParkinsonWhite Syndrome.