The value of the accessory pathway potential in ablation within coronary sinus

Abstract

Background In accessory pathway-related supraventricular tachycardia ablation, coronary sinus (CS) ablation has received more and more attention, but there are no accurate criteria for catheter selection. Objectives We intended to develop a new method for the reasonable selection of electrode for coronary sinus ablation via assessing the relationship between the accessory pathway (AP) potential and time of successful ablation. Methods Among the patients who had detected the bypass potential during radiofre-quency ablation between 1/1/2015 and 12/31/2019, 30 patients underwent radiofrequency catheter ablation (RFCA) in CS. The relationship between AP potential and time of successful ablation was analyzed. Results In CS ablation, the median baseline amplitude of the AP potentials in patients with successful Temperature control catheter (TCC) ablation was higher than that in patients with Irrigated-tip catheter (ITC) following TCC ablation failure (p = 0.02). The optimal cutoff value of the amplitude of the AP potential to guide the selection of a catheter for ablation was 1.07 mV, and the sensitivity and specificity were 80% and 90%, respectively. Conclusions The AP potential is helpful for the electrode selection in CS ablation.