Abstract 14220: Evidence of an Electrical Connection Between the Distal Coronary Sinus and the Left Atrial Appendage
Introduction: Ablation of extra PV triggers improves the outcome of atrial fibrillation (AF) ablation in patients with persistent and long standing persistent AF. The left atrial appendage (LAA) is an underestimated non pulmonary vein trigger. Although the electrical isolation of the LAA remains controversial for the need of long term anticoagulation, its isolation has shown to improve the outcome at follow up. The aim of our study is to report the prevalence of unsusual pattern of isolation from the LAA.
Methods: 192 consecutive patients undergoing catheter ablation of persistent and long standing persistent atrial fibrillation and showing firing from the LAA at the time of the procedure were enrolled in this multicenter prospective study. Isolation of the LAA was guided by placement of the circular catheter at the base of the LAA either with circumferential or segmental lesion.
Results: In 23% of the cases (45 pts), the isolation of the LAA also isolated the distal coronary sinus (figure). In all these cases LAA dissociated firing was present together with the CS recording. No peri-procedural complications were reported.
Conclusion: This observational study highlights the presence of an electrical connection between the LAA and the distal coronary sinus in nearly one fourth of the patients. The clinical relevance of this finding warrants further investigation.
- © 2011 by American Heart Association, Inc.