Vnitr Lek 2011, 57(1):33-42

Characterization of residual coronary sinus-related tachycardia during ablation of longstanding persistent atrial fibrillation

M. Fiala^1,2,*, J. Chovančík¹, D. Wojnarová¹, V. Bulková¹, J. Pindor¹, H. Szymeczek¹, R. Lábrová², O. Toman², J. Januška¹, J. Špinar²

¹ Department of Cardiology, Heart Center, Hospital Podlesí, Třinec, head prim. Marian Branny, M.D.

² Department of Cardiology Medical Faculty Masaryk University and University Hospital, Brno, head prof. Jindřich Špinar, M.D., Ph.D., F.E.S.C.

Purpose:
The aim was to characterize the coronary sinus (CS)-related tachycardia that occurred as the last residual arrhythmia and required ablation within the CS or great cardiac vein to restore sinus rhythm (SR) in patients with primary longstanding persistent AF.

Methods:
The study included 23 patients in whom stable SR was restored by ablation inside the vein during the first or repeat ablation.

Results:
The 23 subjects represented 23% of the 99 patients in whom SR was restored by ablation. A reentry tachycardia confined to the CS musculature was suggested in 8 (35%) patients, and a peri-mitral reentry circuit was present in 14 (61%) patients. Twenty (87%) patients have remained free from arrhythmia and class I or III antiarrhythmic drugs for 33 ± 10 (12-53) months.

Conclusion:
A majority of the residual CS-related tachycardias exhibit properties of reentry, one third utilizing the CS musculature as a reentry substrate independent of the atrial myocardium.

Keywords: atrial fibrillation; persistent; ablation; coronary sinus; tachycardia

Received: March 9, 2010; Accepted: August 11, 2010; Published: January 1, 2011  Show citation