Key result
Distal CS ablation successfully treats antidromic AVRT involving a unique left anteroseptal Mahaim-like pathway.
Case Report (n=1)
No
This case highlights the utility of the coronary venous system as an accessible vascular network for the evaluation and catheter ablation of unique Mahaim-like accessory pathways involving distal CS musculature.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for distal CS ablation in rare Mahaim-like pathways; leaves open generalizability and safety from this single case.
A 40-year-old man presented to our emergency department 2 hours after onset of shortness of breath, palpitations, and presyncope secondary to an adenosine-responsive wide complex tachycardia. Electrophysiology study was diagnostic for antidromic atrioventricular (AV) reentrant tachycardia utilizing a muscular connection from the anterior interventricular vein to the left ventricle with Mahaim-like properties, successfully treated with ablation in the distal coronary sinus (CS) system. This case highlights accessory pathways (a) with unique features (i.e., Mahaim-like characteristics) and (b) involving musculature from the distal CS system, thereby limiting the value of endocardial ablation for durable treatment. Importantly, the coronary venous system is an accessible vascular network for evaluation and catheter ablation of such arrhythmias.
No takes yet. Share an insight, caveat, or question.
Sandhu et al. (2020) conducted a case report in Antidromic atrioventricular reentrant tachycardia (n=1). Catheter ablation in the distal coronary sinus system was evaluated on Successful ablation. Catheter ablation in the distal coronary sinus system successfully treated an antidromic AVRT utilizing a unique left anteroseptal Mahaim-like accessory pathway.
Synapse has enriched 10 related papers. Consider them for comparative context: