Key result
Left-sided septal radiofrequency ablation via an unroofed coronary sinus successfully eliminated fast/slow atypical AVNRT after conventional right-sided ablation failed, with no recurrence at 18 months.
Case Report (n=1)
No
Atypical fast/slow AVNRT in a patient with an unroofed coronary sinus can be successfully treated with left-sided septal ablation when conventional right-sided ablation fails.
May be considered in refractory atypical AVNRT with unroofed CS; leaves open need for systematic evaluation.
Unroofed coronary sinus is a rare congenital anomaly that may alter the complex anatomy of the atrioventricular (AV) node. Arrhythmia circuits occurring among these patients may not be located in the usual position, especially those circuits involving the AV node. We report a case of the coexistence of this uncommon coronary sinus (CS) anomaly and the atypical form of atrioventricular nodal reentrant tachycardia (AVNRT) that could not be ablated by the conventional right-sided slow pathway modification but required left-sided septal ablation through an unroofed CS.
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Morales et al. (2015) conducted a case report in Fast/slow atypical AVNRT with unroofed coronary sinus (n=1). Left-sided septal radiofrequency ablation via unroofed coronary sinus vs. Conventional right-sided slow pathway modification (failed) was evaluated on Arrhythmia recurrence and inducibility. Left-sided septal radiofrequency ablation via an unroofed coronary sinus successfully eliminated fast/slow atypical AVNRT after conventional right-sided ablation failed, with no recurrence at 18 months.
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