Key result
A residual left atrial-to-coronary sinus connection can serve as an epicardial bypass to maintain recurrent perimitral atrial tachycardia despite endocardial conduction block at the mitral isthmus.
Case Report (n=1)
Highlights that a residual left atrial-to-coronary sinus connection can serve as an epicardial bypass to maintain recurrent perimitral atrial tachycardia despite endocardial conduction block at the mitral isthmus.
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May warrant epicardial mapping in recurrent perimitral AT after mitral isthmus block; leaves open optimal ablation strategies.
M itral isthmus (MI) ablation is one of the important steps in the context of persistent atrial fibrillation ablation. However, achieving a complete transisthmus conduction block is challenging. Furthermore, incomplete conduction block can increase the risk of recurrent perimitral atrial tachycardia (AT). We describe a case wherein endocardial conduction block across the MI line was established, but a residual left atrial-to-coronary sinus (LA-CS) connection served as an epicardial bypass to maintain recurrent perimitral AT.
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Miyazaki et al. (2011) conducted a case report in Recurrent perimitral atrial tachycardia (n=1). Mitral isthmus ablation was evaluated on Recurrent perimitral atrial tachycardia. A residual left atrial-to-coronary sinus connection can serve as an epicardial bypass to maintain recurrent perimitral atrial tachycardia despite endocardial conduction block at the mitral isthmus.
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