Radiofrequency catheter ablation for atrioventricular nodal reentrant tachycardia in a patient with persistent left superior vena cava

Persistent left superior vena cava associated with common type AV nodal reentrant tachycardia and AV reentrant tachycardia due to concealed left lateral accessory pathway

“…The optimal ablation site of AV node slow pathway ablation in these patients remains unclear, due to atypical courses of the AV node slow pathway [1]. The area of the coronary sinus ostium and the posteroinferior region of Koch's triangle [2] are suggested sites of successful ablation. In our patients successful ablation was performed in the second site, for all of the 5 patients treated.…”

Partial Unroofed Coronary Sinus Associated With Upper Septal Ventricular Tachycardia and Atrioventricular Nodal Reentrant Tachycardia

“…Similar QRS morphology during sinus rhythm and ventricular tachycardia suggested exit site in the His-Purkinjee system and spread of the impulse to the myocardium via the same. AVNRT in association with large coronary sinus due to persistent left SVC have been described earlier [6., 7., 8.], but not in association with partial unroofing.…”

Systemic venous anatomy in congenital heart disease: implications for electrophysiologic testing and catheter ablation

“…A dilated coronary sinus associated with persistent left SVC has been associated with arrhythmogenesis [32][33][34][35]. An enlarged coronary sinus may also affect the triangle of Koch with important implications for slow pathway ablation in atrioventricular nodal reentrant tachycardia [36][37][38]. Device implantation can also be more complicated in the setting of a persistent left SVC [39,40].…”