A case of accessory pathway mapped with ultra-high-resolution mapping led to a coronary sinus diverticulum

Area of Science:

• Cardiology
• Electrophysiology
• Medical Imaging

Background:

• Accessory pathway ablation is crucial for treating supraventricular tachycardias.
• Ultra-high-resolution mapping enhances ablation precision.
• Coronary sinus (CS) diverticulum can complicate accessory pathway ablation.

Observation:

• Patients with accessory pathways within a CS diverticulum pose unique ablation challenges.
• Subepicardial accessory pathways may be associated with venous anomalies.
• CS angiography is a potential diagnostic tool for these anomalies.

Findings:

• Endocardial ablation in CS diverticulum accessory pathways is technically demanding.
• Identifying subepicardial pathways necessitates evaluating associated venous structures.
• CS angiography can visualize venous anomalies relevant to pathway location.

Implications:

• Improved diagnostic strategies are needed for challenging accessory pathway locations.
• Further research into ablation techniques for CS diverticulum pathways is warranted.
• Accurate anatomical assessment using CS angiography can guide ablation procedures.