22 Jul 2019 Novedades

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.


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