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Coronary sinus ablations in pediatric patients with supraventricular arrhythmias

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Abstract

Background

Intracoronary sinus ablations have been performed for various arrhythmical substrates. The aim of this study is to report our experience on pediatric patients of the safety and efficacy of ablations in the coronary sinus.

Methods

This is a retrospective study of all patients who underwent ablations in the coronary sinus from October 2013 to October 2021 at a single center. Clinical presentation, type of arrhythmia causing tachycardia, ablation procedure, and outcome were recorded.

Results

A total of 27 patients were included in the study. Nineteen (69%) of those followed up received a diagnosis of Wolff-Parkinson-White syndrome (WPW), 4 (15%) were cases of supraventricular tachycardia with concealed accessory pathway (AP), 2 (8%) were cases of focal atrial tachycardia, and 2 (8%) were cases of permanent junctional reciprocating tachycardia. Negative delta wave was noteworthy especially in lead II in 11/19 (58%) cases and coronary sinus diverticulum was detected in the WPW cases. Of those with manifest AP (19 cases), 15 (79%) had a high-risk AP and the AP in all WPW cases was adenosine unresponsive. Radiofrequency (RF) catheter ablation was performed in 25/27 (93%) cases during the procedure, and 16/25 (64%) of these were irrigated RF catheters. No complications were observed in the follow-up, including coronary artery injury.

Conclusions

Catheter ablation of supraventricular tachyarrhythmias can be accomplished effectively and potentially safely within the coronary sinus. Coronary sinus diverticula should be suspected in patients with manifest posteroseptal APs who have a previous failed ablation and typical electrocardiographic signs.

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Abbreviations

WPW:

Wolff-Parkinson-White syndrome

FAT:

Focal atrial tachycardia

AP:

Accessory pathway

PJRT:

Permanent junctional reciprocating tachycardia

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Authors and Affiliations

  1. Department of Pediatric Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, Bezirganbahce Street, Halkali, Istanbul, 34303, Turkey

    Hacer KAMALI, H. Candas KAFALI, Bahar CARAN, Ayşe SULU & Yakup ERGUL

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  1. Hacer KAMALI
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  2. H. Candas KAFALI
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  3. Bahar CARAN
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  4. Ayşe SULU
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  5. Yakup ERGUL
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Correspondence to Hacer KAMALI.

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Ethical standards

The authors assert that all procedures contributing to this work comply with the ethical standards of the institutional research committee (Approval number: 2022.06.41) and with the Helsinki declaration of 1975, as revised in 2008, and have been approved by the institutional committees.

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The authors declare no competing interests.

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Content of the manuscript was presented as an oral presentation (abstract no. “307”) with the name of “Coronary sinus ablation in pediatric patients with supraventricular arrhythmias; eight years single-center experience” at the “AEPC 2022 Annual Meeting.”.

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KAMALI, H., KAFALI, H.C., CARAN, B. et al. Coronary sinus ablations in pediatric patients with supraventricular arrhythmias. J Interv Card Electrophysiol 66, 2153–2164 (2023). https://doi.org/10.1007/s10840-023-01675-w

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  • DOI: https://doi.org/10.1007/s10840-023-01675-w

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