Abstract 1836: Usefulness of Unipolar Electrical Recordings in the Coronary Sinus during Atrial Fibrillation for Differentiation of Coronary Sinus and Left Atrial Potentials
Muscle bundles identified in the coronary sinus (CS) has been shown to contribute to the initiation and maintenance of paroxysmal atrial fibrillation (AF).
Purpose: We sought to identify CS muscular bundles potential and compare CS potential and CS musculature distribution using intravascular ultrasound (IVUS).
Methods: Bipolar (BP) and unipolar (UP) electrograms were recorded using decapolar 5–5–5mm spacing electrode catheter with central lumen during sinus rhythm (SR) and AF in 15 patients (52.3±16.7 years, range: 23–76 years) who underwent catheter ablation for supraventricular and ventricular tachycardia (WPW syndrome: 8, AV nodal reentrant tachycardia: 4 patients, atrial tachycardia: 1 patient, atrial flutter: 1 patient, idiopathic right ventricular tachycardia: 1 patient). The proximal pole of the electrode was adjusted to locate at the CS ostium by CS venography. After recording of the CS potentials, an IVUS (3.2 F, 30 MHz, Boston Scientific) catheter was inserted in the distal CS and CS images were obtained from distal CS to CS ostium during pulling back every 0.2 mm triggered by electrocardiogram and respiration. CS musculature distribution was reconstructed along the CS using 3-D reconstruction system (USE-1200, TomTec Imaging Systems).
Results: CSP and left atrial potentials (LAP) could not be differentiated during SR, but it could be differentiated during AF; CS potentials showed high frequency, spiky potentials and LA potential showed low frequency dull potentials in the UP electrograms. CS musculature distribution correlated with CS potentials (Figure⇓).
Conclusion: Unipolar CSP recording during AF is useful to identify CS musculature distribution.