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Iterative atrial tachycardia originating from the coronary sinus musculature

M Tritto1, M Zardini, R De Ponti

  • 1Cardiology Department Mater Domini, Castellanza, Varese, Italy. m.tritto@libero.it

Journal of Cardiovascular Electrophysiology
|November 9, 2001
PubMed

Insights

Iterative atrial tachycardia can cause dilated cardiomyopathy. Radiofrequency ablation targeting the coronary sinus muscular sleeves successfully treated the tachycardia and reversed the cardiomyopathy.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Imaging

Background:

  • Iterative atrial tachycardia can lead to heart muscle dysfunction.
  • Dilated cardiomyopathy is a serious condition affecting heart pumping ability.

Observation:

  • A patient presented with tachycardia causing dilated cardiomyopathy.
  • Electrophysiologic study revealed irregular tachycardia with atrial activation changes.
  • Mapping identified earliest activation near the mitral annulus, but coronary sinus recordings were key.

Findings:

  • Radiofrequency ablation in the coronary sinus region eliminated the tachycardia.
  • No vessel damage occurred post-ablation.
  • The patient recovered fully, with improved left ventricular function.

Implications:

  • Muscular sleeves surrounding the coronary sinus may cause tachycardia.
  • Tachycardia-induced cardiomyopathy is reversible with successful ablation.
  • This case highlights a potential mechanism and treatment for this condition.

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