Radiofrequency catheter ablation for Wolff-Parkinson-White syndrome associated with a coronary sinus diverticulum. 1991

M D Lesh, and G Van Hare, and A K Kao, and M M Scheinman
Department of Medicine, University of California, San Francisco 94143.

The case of a patient with Wolff-Parkinson-White syndrome undergoing attempted radiofrequency catheter ablation of a left posterior paraseptal accessory pathway is described. Coronary sinus venography revealed the presence of a large diverticulum attaching near the os. The electrogram recorded from a catheter placed in the narrow neck of the diverticulum revealed a very short atrioventricular time during sinus rhythm. The pathway was easily ablated using radiofrequency energy applied in the neck of the diverticulum, after multiple failed attempts at catheter ablation from the endocardial surface of the mitral annulus. Our report emphasizes the importance of searching for a coronary sinus diverticulum in all patients with posterior accessory pathways undergoing catheter ablation.

UI MeSH Term Description Entries
D008297 Male Males
D011846 Radio Waves Electromagnetic waves with frequencies between about 3 kilohertz (very low frequency - VLF) and 300,000 megahertz (extremely high frequency - EHF). They are used in television and radio broadcasting, land and satellite communications systems, radionavigation, radiolocation, and DIATHERMY. The highest frequency radio waves are MICROWAVES. Hertzian Waves,High Frequency Waves,Radiowave,Radiowaves,Short Waves,Very High Frequency Waves,Frequency Wave, High,Frequency Waves, High,High Frequency Wave,Radio Wave,Short Wave,Wave, High Frequency,Wave, Radio,Wave, Short,Waves, Hertzian,Waves, High Frequency,Waves, Radio,Waves, Short
D002304 Cardiac Pacing, Artificial Regulation of the rate of contraction of the heart muscles by an artificial pacemaker. Pacing, Cardiac, Artificial,Artificial Cardiac Pacing,Artificial Cardiac Pacings,Cardiac Pacings, Artificial,Pacing, Artificial Cardiac,Pacings, Artificial Cardiac
D003327 Coronary Disease An imbalance between myocardial functional requirements and the capacity of the CORONARY VESSELS to supply sufficient blood flow. It is a form of MYOCARDIAL ISCHEMIA (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels. Coronary Heart Disease,Coronary Diseases,Coronary Heart Diseases,Disease, Coronary,Disease, Coronary Heart,Diseases, Coronary,Diseases, Coronary Heart,Heart Disease, Coronary,Heart Diseases, Coronary
D004240 Diverticulum A pouch or sac developed from a tubular or saccular organ, such as the GASTROINTESTINAL TRACT. Diverticulosis,Diverticula
D004562 Electrocardiography Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY. 12-Lead ECG,12-Lead EKG,12-Lead Electrocardiography,Cardiography,ECG,EKG,Electrocardiogram,Electrocardiograph,12 Lead ECG,12 Lead EKG,12 Lead Electrocardiography,12-Lead ECGs,12-Lead EKGs,12-Lead Electrocardiographies,Cardiographies,ECG, 12-Lead,EKG, 12-Lead,Electrocardiograms,Electrocardiographies, 12-Lead,Electrocardiographs,Electrocardiography, 12-Lead
D004564 Electrocoagulation Procedures using an electrically heated wire or scalpel to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. It is different from ELECTROSURGERY which is used more for cutting tissue than destroying and in which the patient is part of the electric circuit. Diathermy, Surgical,Electrocautery,Endocavitary Fulguration,Galvanocautery,Surgical Diathermy,Thermocoagulation,Fulguration, Endocavitary
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D014927 Wolff-Parkinson-White Syndrome A form of ventricular pre-excitation characterized by a short PR interval and a long QRS interval with a delta wave. In this syndrome, atrial impulses are abnormally conducted to the HEART VENTRICLES via an ACCESSORY CONDUCTING PATHWAY that is located between the wall of the right or left atria and the ventricles, also known as a BUNDLE OF KENT. The inherited form can be caused by mutation of PRKAG2 gene encoding a gamma-2 regulatory subunit of AMP-activated protein kinase. WPW Syndrome,Anomalous Ventricular Excitation Syndrome,Auriculoventricular Accessory Pathway Syndrome,False Bundle-Branch Block Syndrome,Ventricular Pre-Excitation with Arrhythmia,Wolf-Parkinson-White Syndrome,Syndrome, WPW,Syndrome, Wolf-Parkinson-White,Syndrome, Wolff-Parkinson-White,Wolf Parkinson White Syndrome,Wolff Parkinson White Syndrome

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