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Cardiol J. 2008;15(2):181-5.

Early septal activation, successful lateral ablation.

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  • 1Department of Pacemaker and Cardiac Electrophysiology, Rajaie Cardiovascular Medical and Research Centre, Tehran, Iran.


The coronary sinus activation pattern is an important clue for the detection of arrhythmia mechanisms and/or localization of accessory pathways. Any change in this pattern during radiofrequency ablation should be evaluated carefully to recognize the presence of another accessory pathway or innocence of the accessory pathway during arrhythmia. Intra-atrial conduction block can change the coronary sinus activation pattern. Negligence regarding this phenomenon can cause irreversible complications. Here we describe a case with left lateral accessory pathway conduction in which intra-atrial conduction block completely reversed the coronary sinus activation pattern.

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