Refractory supraventricular tachycardia from a coronary sinus diverticulum leading to cardiogenic shock: a challenging ablation case
A 58-year-old male with a past medical history of radiofrequency ablation of a concealed posteroseptal accessory pathway presented to the emergency department with palpitations and acute heart failure. The electrocardiogram showed narrow QRS tachycardia with a heart rate of 170 bpm. Despite boluses...
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| Language: | English |
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PAGEPress Publications
2025-06-01
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| Series: | Monaldi Archives for Chest Disease |
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| Online Access: | https://www.monaldi-archives.org/macd/article/view/3385 |
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| author | Marta Catarina Bernardo Isabel Moreira Catarina Ribeiro Carvalho José Pedro Guimarães Luís Adão Sílvia Leão Sofia Silva Carvalho José Ilídio Moreira |
| author_facet | Marta Catarina Bernardo Isabel Moreira Catarina Ribeiro Carvalho José Pedro Guimarães Luís Adão Sílvia Leão Sofia Silva Carvalho José Ilídio Moreira |
| author_sort | Marta Catarina Bernardo |
| collection | DOAJ |
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A 58-year-old male with a past medical history of radiofrequency ablation of a concealed posteroseptal accessory pathway presented to the emergency department with palpitations and acute heart failure. The electrocardiogram showed narrow QRS tachycardia with a heart rate of 170 bpm. Despite boluses of adenosine and amiodarone perfusion, the patient experienced recurrent supraventricular tachycardia (SVT), leading to cardiogenic shock. Extracorporeal membrane oxygenation was initiated for hemodynamic support. Electrophysiologic study identified an accessory pathway in a coronary sinus diverticulum. Successful radiofrequency ablation was performed, resulting in clinical and left ventricular ejection fraction improvement. This case highlights the challenges in managing incessant SVT with cardiogenic shock and complex ablation procedures.
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| format | Article |
| id | doaj-art-9c9d30ff981c4a4b9daa72783c7deca0 |
| institution | Kabale University |
| issn | 1122-0643 2532-5264 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Monaldi Archives for Chest Disease |
| spelling | doaj-art-9c9d30ff981c4a4b9daa72783c7deca02025-08-20T03:25:25ZengPAGEPress PublicationsMonaldi Archives for Chest Disease1122-06432532-52642025-06-0110.4081/monaldi.2025.3385Refractory supraventricular tachycardia from a coronary sinus diverticulum leading to cardiogenic shock: a challenging ablation caseMarta Catarina Bernardo0https://orcid.org/0009-0005-8753-4615Isabel Moreira1Catarina Ribeiro Carvalho2José Pedro Guimarães3Luís Adão4Sílvia Leão5Sofia Silva Carvalho6José Ilídio Moreira7Department of Cardiology, Trás-os-Montes and Alto Douro Local Health Unit, Vila RealDepartment of Cardiology, Trás-os-Montes and Alto Douro Local Health Unit, Vila RealDepartment of Cardiology, Trás-os-Montes and Alto Douro Local Health Unit, Vila RealDepartment of Cardiology, Trás-os-Montes and Alto Douro Local Health Unit, Vila RealDepartment of Cardiology, São João Local Health UnitDepartment of Cardiology, Trás-os-Montes and Alto Douro Local Health Unit, Vila RealDepartment of Cardiology, Trás-os-Montes and Alto Douro Local Health Unit, Vila RealDepartment of Cardiology, Trás-os-Montes and Alto Douro Local Health Unit, Vila Real A 58-year-old male with a past medical history of radiofrequency ablation of a concealed posteroseptal accessory pathway presented to the emergency department with palpitations and acute heart failure. The electrocardiogram showed narrow QRS tachycardia with a heart rate of 170 bpm. Despite boluses of adenosine and amiodarone perfusion, the patient experienced recurrent supraventricular tachycardia (SVT), leading to cardiogenic shock. Extracorporeal membrane oxygenation was initiated for hemodynamic support. Electrophysiologic study identified an accessory pathway in a coronary sinus diverticulum. Successful radiofrequency ablation was performed, resulting in clinical and left ventricular ejection fraction improvement. This case highlights the challenges in managing incessant SVT with cardiogenic shock and complex ablation procedures. https://www.monaldi-archives.org/macd/article/view/3385Incessant supraventricular tachycardiacardiogenic shockextracorporeal membrane oxygenationcoronary sinus diverticulum |
| spellingShingle | Marta Catarina Bernardo Isabel Moreira Catarina Ribeiro Carvalho José Pedro Guimarães Luís Adão Sílvia Leão Sofia Silva Carvalho José Ilídio Moreira Refractory supraventricular tachycardia from a coronary sinus diverticulum leading to cardiogenic shock: a challenging ablation case Monaldi Archives for Chest Disease Incessant supraventricular tachycardia cardiogenic shock extracorporeal membrane oxygenation coronary sinus diverticulum |
| title | Refractory supraventricular tachycardia from a coronary sinus diverticulum leading to cardiogenic shock: a challenging ablation case |
| title_full | Refractory supraventricular tachycardia from a coronary sinus diverticulum leading to cardiogenic shock: a challenging ablation case |
| title_fullStr | Refractory supraventricular tachycardia from a coronary sinus diverticulum leading to cardiogenic shock: a challenging ablation case |
| title_full_unstemmed | Refractory supraventricular tachycardia from a coronary sinus diverticulum leading to cardiogenic shock: a challenging ablation case |
| title_short | Refractory supraventricular tachycardia from a coronary sinus diverticulum leading to cardiogenic shock: a challenging ablation case |
| title_sort | refractory supraventricular tachycardia from a coronary sinus diverticulum leading to cardiogenic shock a challenging ablation case |
| topic | Incessant supraventricular tachycardia cardiogenic shock extracorporeal membrane oxygenation coronary sinus diverticulum |
| url | https://www.monaldi-archives.org/macd/article/view/3385 |
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