射频消融位于冠状静脉窦憩室处的后间隔房室旁路

目的报道５例冠状静脉窦憩室处后间隔房室旁路的射频消融结果。方法对５例后间隔显性房室旁路患者进行电生理检查和射频消融术。术后冠状动脉造影，以观察冠状静脉窦形态。结果所有患者的冠状静脉窦近端有一憩室，并在憩室的颈部消融阻断房室旁路。成功靶点图：心室激动较体表心电图Δ波提前（３１±３．７）ｍｓ，其中４例患者伴有旁路电位。结论冠状静脉窦憩室与后间隔旁路存在着解剖关系。术中冠状静脉窦造影检查有助于发现憩室和确定有效的消融部位。

Radiofrequency catheter ablation of a posteroseptal accessory pathway within a coronary sinus diverticulum

Objective To report the result of radiofrequency catheter ablation for five patients with posteroseptal accessory pathway within coronary sinus diverticulum. Methods Electrophysiologic study and radiofrequency catheter ablation were performed in five patients with overt posteroseptal accessory pathway.The morphologic features of the coronary sinus was also studied with coronary angiography. ResultsWT5BZA diverticulum attaching the proximal coronary sinus was found and the associated accessory pathway was successfully ablated at the neck of diverticulum in all of these five patients.Local ventricular activation at the successful sites was (3137) ms earlier than the delta wave,and in four patients an accessory pathway potential was recorded. Conclusions Coronary sinus diverticulum is anatomically intimately related to the posteroseptal accessory pathway.Coronary venography during the ablation session is very helpful to detect the diverticulum and identify the effective ablation site.