Document Detail

Angiographic analysis of the anatomic relation of coronary arteries to mitral and tricuspid annulus and implications for radiofrequency ablation.
MedLine Citation:
PMID:  17697826     Owner:  NLM     Status:  MEDLINE    
Coronary artery (CA) narrowings and/or occlusions after radiofrequency ablation (RFA) have been reported. The aim of this study was to describe the in vivo topographic anatomy of CAs and their anatomic relation to the mitral and tricuspid annulus using selective coronary angiography. Fifty consecutive patients undergoing RFA for narrow QRS complex tachycardia were included in the study. Multipolar electrode catheters were inserted into the right atrial appendage, His bundle region, distal coronary sinus (CS), and right ventricle. A mapping catheter was placed across the subeustachian isthmus (SEI). Selective coronary angiography was performed. The maximum and minimum distances between the distal CAs and the mapping catheter located along the mitral and tricuspid annulus were measured during systole and diastole and in right and left anterior oblique projections. The large (> or =1.5 mm) distal right CA was < or =5 mm from the mapping catheter in the SEI in 4 patients (8%). The large posterolateral branch of the right CA was < or =2 mm from the CS Os-middle cardiac vein in 10 patients (20%). The large left circumflex CA was < or =2 mm from the floor or ceiling of the CS in 7 patients (14%) and < or =2 mm from the CS catheter at the lateral and anterolateral mitral annulus in 12 patients (24%). RFA was canceled in 2 patients because of the close proximity (< or =2 mm) of the distal CA to the ablation site. In conclusion, large CAs are frequently located in close proximity to the common ablation sites. Coronary angiography should be considered in children and adults who may develop any signs or symptoms suggestive of acute CA occlusion until larger controlled series are available.
Can Hasdemir; Oguz Yavuzgil; Serdar Payzin; Mehmet Aydin; Cem Ulucan; Meral Kayikcioglu; Levent H Can; Cuneyt Turkoglu; Hakan Kultursay
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Publication Detail:
Type:  Journal Article     Date:  2007-06-27
Journal Detail:
Title:  The American journal of cardiology     Volume:  100     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-08-16     Completed Date:  2007-09-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  666-71     Citation Subset:  AIM; IM    
Department of Cardiology, Ege University School of Medicine, Izmir, Turkey.
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MeSH Terms
Arrhythmias, Cardiac / radiography,  surgery*
Catheter Ablation / adverse effects,  methods*
Coronary Angiography*
Coronary Stenosis / etiology,  radiography
Coronary Vessels*
Follow-Up Studies
Middle Aged
Mitral Valve / radiography*
Postoperative Complications
Predictive Value of Tests
Prospective Studies
Tricuspid Valve / radiography*

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