Coronary sinus morphology in pediatric patients with supraventricular tachycardia

Matthew B. Ambrose, Jennifer N. Avari Silva, Michael Rudokas, Tammy M. Bowman, Joshua Murphy, George F. Van Hare

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Purpose: The anatomic basis of atrioventricular node reentrant tachycardia (AVNRT) remains incompletely characterized in children. Differences in coronary sinus (CS) size and morphology have been observed in adults with AVNRT but have not been well characterized in children. Methods: Children (OpenSPiltSPi 18 years) brought to the EP lab with supraventricular tachycardia for ablation underwent CS venography. A blinded pediatric interventional cardiologist performed CS measurements, which were indexed to body surface area. Patients were excluded if they were OpenSPiltSPi 25 kg or had significant congenital heart disease. Results: Forty-six patients (age 14.2 ± 3.3 years) met inclusion criteria, 17 with AVNRT and 32 with an accessory pathway (AP). CS ostium (LAO projection, end-systole) was 7.8 ± 2.9 mm/m2 for the AVNRT group versus 6.0 ± 2.5 mm/m2 for the AP group (p = 0.04). CS “windsock” morphology was more prevalent in the AVNRT group (16/17, 94.1%) than the AP group (11/32, 34.3%) (p OpenSPiltSPi 0.001). Within the AVNRT group, there was no correlation between CS ostium size and tachycardia cycle length (R = 0.01, p = 0.96), fast-pathway ERP (FPERP) (R = 0.42, p = 0.12), or A2-H2 at the FPERP (R = 0.25, p = 0.39). Conclusions: Children with AVNRT have larger CS ostia and more prevalent windsock morphology. CS size/morphology did not correlate with EP properties of the AVNRT substrate. These features may explain the basis for the development of the electrophysiologic substrate for dual AV node physiology in children.

Original languageEnglish
Pages (from-to)163-168
Number of pages6
JournalJournal of Interventional Cardiac Electrophysiology
Issue number2
StatePublished - Mar 1 2018


  • Ablation
  • Accessory pathway
  • Atrioventricular node reentrant tachycardia
  • Coronary sinus
  • Pediatric electrophysiology
  • Supraventricular tachycardia


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