Key result
Sheath-guided coronary sinus blood sampling during catheter ablation achieves a ~96% success rate without serious complications.
Why the study?
Coronary sinus blood sampling provides insight into localized cardiac pathophysiology, but previously required additional specifically-designed or modified catheters that limited clinical convenience.
Is a simple method for coronary sinus blood sampling using standard catheters feasible and safe during catheter ablation of arrhythmias?
Observational (n=119)
No
Is a simple method for coronary sinus blood sampling using standard catheters feasible and safe during catheter ablation of arrhythmias?
A simple method for coronary sinus blood sampling during catheter ablation using standard catheters is highly feasible, safe, and yields distinct cardiometabolic profiles compared to peripheral blood.
May enable CS sampling during ablation for research; hypothesis-generating for cardiometabolic profiling without supporting routine adoption.
Background: Coronary sinus (CS) blood sampling gives an insight into the localized pathophysiology of heart diseases. However, additional specifically-designed or modified catheters were needed in most previous studies, making the convenience of clinical application unsatisfactory. This study aimed to introduce a simple method for CS blood sampling without using additional catheters during catheter ablation (CA) of arrhythmias, and to investigate its feasibility and safety. Methods: introducer sheath (St. Jude Medical) guided by a 6F steerable diagnostic catheter (St. Jude Medical). The success rate and any suspicious complications were recorded. Untargeted liquid chromatograph-mass spectrometer (LC-MS)-based metabonomics of CS samples versus peripheral venous samples were also performed. Results: CS blood samples were successfully collected from 114 patients, with an overall success rate of 95.8%. Among patients with different arrhythmias, the success rates were similar, with 96.0% in PSVT, 96.7% in PVC, and 95.3% in AF (P=0.223). Adverse events occurred in four (3.4%) patients, including two patients with occasional atrial ectopic beats without causing any discomfort, and two patients with new-onset paroxysmal AF lasting for about 2 min. No serious complications were noted. Metabonomics analysis showed that CS samples provided a number of different metabolites (93 in PVST, 217 in PVC, and 109 in AF) versus peripheral samples. Conclusions: Our method for CS blood sampling during CA is feasible and safe, and can provide useful cardiometabolic information that is significantly different from a peripheral sample.
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Zheng et al. (2022) conducted an observational in Arrhythmias (paroxysmal supraventricular tachycardia, premature ventricular complexes, atrial fibrillation) (n=119). Coronary sinus blood sampling using an introducer sheath guided by a 6F steerable diagnostic catheter was evaluated on Success rate of coronary sinus cannulation. A simple method for coronary sinus blood sampling using an introducer sheath guided by a steerable diagnostic catheter during catheter ablation was highly feasible, achieving a 95.8% success rate with no serious complications.
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