Key result
Radiofrequency catheter ablation in the coronary sinus successfully terminated orthodromic atrioventricular reentrant tachycardia in a patient with a mechanical mitral valve, with no recurrence at 10 months.
Why the study?
Accessory pathway ablation at the site of prior valve surgery is rarely reported, challenging, and carries risk of injuring the prosthetic valve.
Case Report (n=1)
No
Ablation of an accessory pathway in the coronary sinus can be successfully performed in patients with a mechanical mitral valve despite the technical challenges and risks.
Successful concealed AP ablation at prior valve site is feasible without prosthetic injury; leaves open safety and reproducibility in larger series.
Patients treated with cardiac surgery often present with supraventricular arrhythmias, classically atrial fibrillation and atrial flutter. Accessory pathways (APs) are a rare finding in these patients, except for congenital heart disease (eg, Ebstein anomaly). Only a few case reports of AP ablation at the site of previous valve surgery have been published.1 Ablation in this setting is challenging and carries the risk of injuring the prosthetic valve. We report a successful ablation of a concealed left-side AP in the coronary sinus (CS) in a patient with previous mechanical mitral valve replacement for rheumatic valve disease.
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Albertini et al. (2022) conducted a case report in Orthodromic atrioventricular reentrant tachycardia with mechanical mitral valve (n=1). Radiofrequency catheter ablation in the coronary sinus was evaluated on Termination of tachycardia and non-inducibility. Radiofrequency catheter ablation in the coronary sinus successfully terminated orthodromic atrioventricular reentrant tachycardia in a patient with a mechanical mitral valve, with no recurrence at 10 months.
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