Giant diverticulum of coronary sinus with multiple accessory pathways treated with catheter ablation

Area of Science:

• Cardiology
• Pediatric Electrophysiology
• Congenital Heart Disease

Background:

• Coronary sinus abnormalities can be symptomatic and associated with cardiac arrhythmias.
• Giant diverticulum of the coronary sinus is a rare congenital anomaly.
• Wolff-Parkinson-White syndrome is a common cause of supraventricular tachycardia in children.

Purpose of the Study:

• To report a case of a pediatric patient with a giant coronary sinus diverticulum and Wolff-Parkinson-White syndrome.
• To describe the successful management of this complex condition using catheter ablation.
• To highlight the efficacy of radiofrequency ablation in treating accessory pathways associated with coronary sinus anomalies.

Main Methods:

• A 5-year-old patient with a giant coronary sinus diverticulum and Wolff-Parkinson-White syndrome was identified.
• Multidrug therapy was initially administered due to inadequate response.
• Catheter ablation targeting posteroseptal and left posterolateral accessory pathways was performed via the coronary sinus.

Main Results:

• Radiofrequency ablation through the coronary sinus successfully eliminated the accessory pathways.
• The patient's arrhythmia disorder was effectively managed post-ablation.
• Successful treatment of a rare congenital anomaly associated with a significant arrhythmia.

Conclusions:

• Catheter ablation is a viable and effective treatment for pediatric patients with giant coronary sinus diverticulum and Wolff-Parkinson-White syndrome.
• Radiofrequency ablation through the coronary sinus can successfully target accessory pathways in complex anatomical variations.
• This case underscores the importance of considering interventional electrophysiology for managing rare congenital cardiac anomalies presenting with arrhythmias.