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BACKGROUND Local electrograms recorded from the coronary sinus and great cardiac vein provide important information for the diagnosis of various arrhythmias and identification of target sites for ablation of left-sided accessory pathways. One limitation of present techniques is the inability, in many cases, to probe the great cardiac vein at the anterior mitral annulus. We tested the feasibility of a new technique for catheterization of the coronary sinus and great cardiac vein by means of a small-diameter electrode catheter advanced via a right femoral approach through an angiography catheter. RESULTS Of 22 patients (12 men and 10 women; ages 44.5 +/- 13.4 years) undergoing radiofrequency ablation of a supraventricular tachycardia, cannulation of the coronary sinus orifice using a 6-French 1L or 2L Amplatz catheter was achieved in 20 patients (91%) within 0.9 +/- 0.6 minutes; after cannulation, a 2-French octapolar electrode catheter with a soft radiopaque tip and a 3-mm interelectrode distance could be advanced in all 20 patients through the guiding catheter to the great cardiac vein in the anterior region of the AV sulcus within 0.8 +/- 0.7 minutes. Atrial and ventricular local potentials were recorded all along the mitral annulus during sinus rhythm, atrial and ventricular pacing, or supraventricular tachycardia. Variation of local potential amplitude never exceeded 20% of the mean and presented similar stability at all annular regions. The arrhythmogenic substrate was identified in all patients. Of 18 patients with 21 left-sided accessory pathways, an accessory pathway potential could be recorded at the ablation site by one or more adjacent epicardial electrode pairs in 10 pathways. No procedure-related complications were observed. CONCLUSIONS The technique introduced in this study proved feasible in 91% of patients. Its main advantages are the simplicity and rapidity of coronary sinus cannulation and the ability to advance the electrode catheter to the anterior cardiac vein. In addition, closely spaced bipolar electrograms resulted in enhanced atrial, ventricular, and accessory pathway potential resolution.
R Cappato, and
M Schlüter, and
C Weiss, and
S Willems, and
T Meinertz, and
K H Kuck
April 2002,
Pacing and clinical electrophysiology : PACE,
R Cappato, and
M Schlüter, and
C Weiss, and
S Willems, and
T Meinertz, and
K H Kuck
September 2020,
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology,
R Cappato, and
M Schlüter, and
C Weiss, and
S Willems, and
T Meinertz, and
K H Kuck
July 1994,
The American journal of cardiology,
R Cappato, and
M Schlüter, and
C Weiss, and
S Willems, and
T Meinertz, and
K H Kuck
August 2020,
Journal of cardiovascular electrophysiology,
R Cappato, and
M Schlüter, and
C Weiss, and
S Willems, and
T Meinertz, and
K H Kuck
December 2025,
Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology,
R Cappato, and
M Schlüter, and
C Weiss, and
S Willems, and
T Meinertz, and
K H Kuck
June 2008,
Journal of cardiovascular electrophysiology,
R Cappato, and
M Schlüter, and
C Weiss, and
S Willems, and
T Meinertz, and
K H Kuck
March 1995,
The American journal of cardiology,
R Cappato, and
M Schlüter, and
C Weiss, and
S Willems, and
T Meinertz, and
K H Kuck
April 2011,
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology,
R Cappato, and
M Schlüter, and
C Weiss, and
S Willems, and
T Meinertz, and
K H Kuck
January 1988,
Revista medico-chirurgicala a Societatii de Medici si Naturalisti din Iasi,
R Cappato, and
M Schlüter, and
C Weiss, and
S Willems, and
T Meinertz, and
K H Kuck
August 1993,
Catheterization and cardiovascular diagnosis,
