The Last Exit Before the Bridge to Epicardium in Ventricular Tachycardia Ablations: Coronary Venous System

The Last Exit Before the Bridge to Epicardium: Coronary Venous System

Abstract

Ventricular arrhythmias originating from epicardial or intramural locations pose clinical challenges for catheter ablation, and the coronary venous system may offer routes for mapping and ablation of these arrhythmias. Percutaneous pericardial access, followed by epicardial mapping and ablation of ventricular arrhythmias, is an essential tool in the arsenal of invasive electrophysiologists. However, the coronary venous system also provides an underexplored pathway for accessing the epimyocardium to map and ablate ventricular arrhythmias arising from epicardial sites. The use of coronary venography, achieved through retrograde injection of contrast medium into the coronary sinus, typically allows for clear visualization of this system's architecture.