Epicardial bridge via the coronary sinus musculatures revealed by ultra-high-definition mapping

Ying Chi Yang; Thein Tun Aung; Hardik Doshi; Steven J Bailin

doi:10.1016/j.jelectrocard.2020.04.015

Epicardial bridge via the coronary sinus musculatures revealed by ultra-high-definition mapping

J Electrocardiol. 2020 Jul-Aug:61:106-111. doi: 10.1016/j.jelectrocard.2020.04.015. Epub 2020 Apr 24.

Authors

Ying Chi Yang¹, Thein Tun Aung², Hardik Doshi², Steven J Bailin²

Affiliations

¹ Department of Internal Medicine, University of Iowa, IA, USA. Electronic address: myomintun3@gmail.com.
² Department of Cardiac Electrophysiology, University of Iowa, IA, USA.

PMID: 32563899
DOI: 10.1016/j.jelectrocard.2020.04.015

Abstract

Mapping and ablation of perimitral flutter, a macro-reentrant tachycardia, can be sometimes challenging. We describe a case of perimitral atrial flutter following the pulmonary vein isolation in which mitral isthmus ablation failed to terminate the arrhythmia due to epicardial-endocardial breakthrough via the muscle fibers of coronary sinus. Ultra-high-definition mapping system was utilized to locate the epicardial bridge, and spot ablation of the lesion subsequently terminated the arrhythmia.

Keywords: Epicardial bridge; Perimitral flutter; Pulmonary veins isolation; Ultra-high-definition mapping.

Publication types

Case Reports

MeSH terms

Atrial Fibrillation* / surgery
Atrial Flutter* / surgery
Catheter Ablation*
Coronary Sinus* / diagnostic imaging
Coronary Sinus* / surgery
Electrocardiography
Humans
Pulmonary Veins* / surgery
Treatment Outcome