Oct 2026· Indian Pacing and Electrophysiology Journal· 0 citations· 60 references
Medicine
TL;DR
The proximity of CS tributaries to the ventricular myocardium provides access for the mapping and ablation of selected ventricular arrhythmias, complementing the established role of these vessels in left ventricular pacing.
Abstract
The coronary sinus (CS) is a specialized cardiac structure whose embryologic and anatomic features may contribute to arrhythmogenesis. Composed of both venous and myocardial elements, it can be conceptualized as a distinct cardiac chamber with connections to both the left and right atria-characteristics that make it an important site for the initiation and maintenance of atrial arrhythmias, as well as a key structure in explaining the underlying physiology of atrioventricular nodal reentrant tachycardia (AVNRT) and the origin of epicardial bypass tracts. The vein, ligament, and myocardial bundle of Marshall arise from the proximal CS and maintain electrical connections with the left atrium and the left-sided pulmonary veins. Because of their electrophysiological and autonomic properties, these structures may contribute to both atrial and ventricular arrhythmias. Furthermore, the proximity of CS tributaries to the ventricular myocardium provides access for the mapping and ablation of selected ventricular arrhythmias, complementing the established role of these vessels in left ventricular pacing.
Left-sided concealed accessory pathways (LCAPs) are a common cause of paroxysmal supraventricular tachycardia (PSVT) treated with radiofrequency ablation (RFA); however, the inferoposterior myocardial bundle, myocardial sleeve connections between the left atrium and coronary sinus (LA-CS), and the creation of mitral is...
Kai-Da Wang, Shang-Yun Zhang, Ya-Jiang Wang et al.· Journal of Electrocardiology· 0 citations
Objectives: The coronary sinus (CS) plays a key role in cardiac electrophysiology, including cardiac resynchronization therapy (CRT) and ablation of arrhythmias such as left-sided accessory pathways, premature ventricular complexes (PVCs), and atrial fibrillation (AF). Some procedures cannot be performed without CS acc...
The left atrial appendage (LAA) is nowadays recognized as both an arrhythmogenic substrate and the dominant source of thromboembolism in atrial fibrillation (AF). In this review we tried to summarize recent data on the anatomy, physiology, and imaging of the LAA, and examine how these findings help guide rhythm-control...
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