Usefulness of omnipolar technology near field for accessory pathway ablation through the coronary sinus

Figures

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  Figure 1. Twelve-lead surface electrocardiograms. A: Atrial fibrillation and pseudo–ventricular tachycardia. The lead in V1 is scaled up (10 mm = 1 mV) and zoomed. Electrical alternance between normal QRS complexes and pre-excited complexes was observed. B: Sinus rhythm. Wide QRS and delta waves are suspected to indicate the presence of an anterograde accessory pathway.

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  Figure 2. Electroanatomical maps for the left atrium and coronary sinus. A: Local activation map during the pacing rhythm from distal coronary sinus (CS) electrodes. The left anterior oblique view. B: Peak frequency map. Left anterior oblique view. The frequency cutoff value was set to 200 Hz. The peak frequency was significantly higher on the CS side (245 Hz) than on the left atrium (LA) side (220 Hz), and the highlighted area of the high peak frequency was more focused on the narrow region in the CS. White triangles indicate annotation points. C: Emphasis map combined with the local activation and peak frequency maps. Left anterior oblique view.

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  Figure 3. Successful ablation site. The red tag on the highlighted area (white arrow) in the coronary sinus (CS) image shows the successful ablation point. The blue tag indicates an unsuccessful ablation point in the left atrium (LA). Light yellow triangle indicates a Kent potential on the intracardiac electrograms recorded in the ablation catheter.