CORONARY VENOUS SYSTEM DISEASES

Coronary_Venous_System_Diseases

CORONARY VENOUS ANATOMY AND ITS ELECTROPHYSIOLOGICAL SIGNIFICANCE

Mehmet Semih Belpınar1 Uğur Küçük2

1Sivas State Hospital, Department of Cardiology, Sivas, Türkiye

2Çanakkale Onsekiz Mart University, Faculty of Medicine, Department of Cardiology, Çanakkale, Türkiye

Belpınar MS, Küçük U. Coronary Venous Anatomy and Its Electrophysiological Significance. In: Altay S, Akşit E, Kemaloğlu Öz T editor. Coronary Venous System Diseases. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.101-110.

ABSTRACT

The coronary venous system (CVS) is a network of vessels that collects deoxygenated blood from the myocardium and returns it to the right atrium. A detailed understanding of the anatomy of the CVS has become increasingly important in contemporary electrophysiology. The venous structures of the heart have significant clinical relevance in various electrophysiological procedures, including arrhythmia ablation, biventricular pacing, and the implantation of several cardiac devices. For instance, a comprehensive examination of the CVS is required in cases of left-sided epicardial accessory path- ways, AVRT, AVNRT, or as part of complex atrial fibrillation (AF) ablation. Similarly, in patients with sustained ventricular tachycardia (VT), the CVS’s anatomy can be visualized using microcatheters, facilitating electrophysiological mapping and enabling the successful ablation of these life-threatening complex tachycardias.

Furthermore, the CVS can exhibit automaticity and contains electrophysiologically active structures with slow conduction properties, serving as a potential arrhythmogenic source. To ensure the safe and effective execution of such procedures, it is crucial to have a thorough understanding of the venous system and its branches, as well as regional anatomy. In particular, familiarity with adjacent anatomical structures and a detailed knowledge of the phrenic nerve, which may be closely associated with these vessels, are essential

Keywords: Coronary venosus system; Cardiac electrophysiology; Arrythmias; Supraventricular tachycardias; Ventricular tachycardias; Ablation; Cathater ablation

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