Coronary sinus diverticulum: Importance, function, and treatment

Abstract

The importance of venous structure in the heart is usually overshadowed by that of the arterial system. Coronary sinus (CS) is a part of cardiac venous apparatus and connects left atria to the right atria. Other than having role in physiological contractions of both atria, it contributes substantially to cardiac electrical conduction system. Due to unique placement and connections of the CS, it has become growing interest in clinical cardiology. It is used in cardiac resynchronization therapy with biventricular pacing, left‐sided catheter ablation of arrhythmias, and administration of retrograde cardioplegia in cardiac surgery. In some individuals, CS is presented with anatomical variants. CS diverticulum is a congenital outpouching that provides muscular connection between atria and ventricle. This connection provides a suitable substrate for occurrence of arrhythmias, which even results in life‐threatening events such as sudden cardiac death. Early diagnosis leads to treatment with ablation techniques, which ultimately eliminates origins of arrhythmias.

Are Coronary Sinus Features Reflecting the Effect of Catheter Ablation of Atrial Fibrillation as P-waves Do?

“…Despite the fact that N(Duration) showed the lowest CQSE values and hence the highest nonlinear correlations, they remained nonsignificant. V. DISCUSSION CS is a critical structure both for the AF perpetuation and for the most important AF therapy, the CA [9]- [11]. So far, its behavior with regard to the CA procedure has been remaining in the dark.…”

“…However, how CA affects local atrial structures which contribute by any means to the AF phenomenon is yet to be explored. Coronary sinus (CS) is a key structure not only for the AF perpetuation but also for the CA procedure [9]- [11]. CS catheterization is a solid CA step, assisting in AF mapping.…”

The Dissimilar Impact in Atrial Substrate Modificationof Left and Right Pulmonary Veins Isolation after Catheter Ablation of Paroxysmal Atrial Fibrillation

“…Coronary sinus’ (CS) strategical position between left (LA) and right atrium (RA) allows the detection of non-PV triggers and PV reconnection gaps throughout the atria during CA procedures via CS catheterization [ 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ]. Despite its extensive use as a CA reference, whether CS analysis could provide reliable information with respect to the AF substrate modification or which channels of CS catheter are the most appropriate for the analysis are two vital issues that remain unexplored.…”

The Relevance of Heart Rate Fluctuation When Evaluating Atrial Substrate Electrical Features in Catheter Ablation of Paroxysmal Atrial Fibrillation

“…During CA, one or more atrial structures are chosen as a reference, and recordings from a stationary catheter are acquired throughout the procedure [ 14 , 15 ]. The coronary sinus (CS) is the most common reference, as it forms an interatrial electrical bridge and can initiate or propagate the AF activity [ 16 , 17 , 18 , 19 , 20 ]. CS catheterization allows the mapping of the entire atria.…”