A 28-year-old man with a history of Hodgkin’s lymphoma presented with productive cough to the hospital. Contrast enhanced computed tomography (CT) of the thorax was performed to assess for lung pathologies. Incidentally, the CT revealed a lack of connection between the coronary sinus (CS) and right atrium (Figures 1A–C) with a persistent left superior vena cava (LSVC) (Figures 2 and 3; GCV, gre...

BACKGROUND We sought to describe the prevalence and variability of coronary sinus (CS) and left atrial (LA) myocardium connections, their susceptibility to rate-dependent conduction block, and association with atrial fibrillation (AF) and flutter induction. METHODS AND RESULTS The study cohort included 30 consecutive AF patients (age 63.3±10.5 years, 63% male). Multipolar catheters were posit...

Biventricular pacing has been considered for the treatment of congestive heart failure secondary to dilatative cardiomyopathy and intraventricular conduction blocks [1]. In the majority of reported cases, the left ventricular lead is positioned via the coronary sinus (CS) [2]. However, the positioning of a CS lead is not always possible, due to anatomical conditions such as coronary sinus valve...

Introduction The coronary sinus (CS) and ligament of Marshall (LOM) have been reported to have arrhythmogenic properties and can initiate atrial fibrillation (AF) triggers as well as participate in left atrial reentrant circuits. In a recent study, epicardial and endocardial ablation of the CS in patients with AF after pulmonary vein isolation prolonged the AF cycle length and terminated AF and...

BACKGROUND Kawasaki disease (KD) is the most common cause of acquired myocardial infarction in children. Coronary artery involvement is the most serious feature of this vasculitis syndrome. Timely diagnosis of coronary artery involvement is of utmost importance since it can prevent long-term morbidity and mortality. The current methods for the diagnosis of coronary artery dilation in KD are inc...

A 31-year-old man with prior step-wise ablation for persistent atrial fibrillation presented with atrial tachycardia (AT). Linear lines for the mitral isthmus, left atrial roof, and the cavo-tricuspid isthmus had previously been performed in addition to pulmonary vein (PV) isolation and defragmentation on the left atrium. The patient was in sinus rhythm (SR) at the beginning of the procedure, s...

AIMS Cardiac resynchronization therapy is an accepted treatment for heart failure but it may be necessary to explant these systems along with their leads. The evidence base for coronary sinus (CS) lead extractions is limited. We aimed to evaluate the percutaneous removal of these leads and the utility of laser extraction when necessary. METHODS AND RESULTS Of 265 patients referred for lead ex...

A 25 year old man underwent electrophysiology study for recurrent symptomatic paroxysmal palpitations. There were no documented episodes of supraventricular tachycardia on surface ECG. Delta waves were absent on baseline ECG. A decapolar catheter was placed in the coronary sinus with the distal and proximal pair of electrodes configured as CS 1-2 and CS 9-10 respectively. Quadripolar catheters ...

BACKGROUND Percutaneous mitral annuloplasty has been proposed as an alternative to surgical annuloplasty. In this respect, evaluation of the coronary sinus (CS) and its relation with the mitral valve annulus (MVA) and the coronary arteries is relevant. The feasibility of evaluating these issues noninvasively with multislice computed tomography was determined. METHODS AND RESULTS In 105 patien...

BACKGROUND Despite technical advancements, implantation of coronary sinus (CS) leads may be challenging, and dislocation remains a relevant clinical problem. OBJECTIVE The aim of this study was to investigate the effectiveness, safety, and long-term outcome of stent implantation to anchor the lead to the wall of the CS side branch. METHODS Stenting of a CS side branch was performed in 312 p...