Placement of the Coronary Sinus Catheter via the Right Cubital Vein
during Atrial Fibrillation Ablation
Abstract
Background: The placement of an electrode catheter into the
coronary sinus (CS) is critical for electrophysiologic studies. While
central venous approaches (e.g., internal jugular or subclavian) are
well-documented, peripheral venous approaches like the cubital vein are
not. This study aimed to evaluate the feasibility and safety of CS
catheter placement via the right cubital vein during atrial fibrillation
(AF) ablation. Methods: Of 1363 consecutive patients who
underwent first-time AF ablation at our institution between January 2019
and December 2021, we investigated 1274 who had at least one attempt at
right cubital vein puncture for CS catheter placement. We evaluated the
success rate, causes of placement failures, and complications associated
with the cubital vein approach. Results: The CS catheters were
successfully placed via the right cubital vein in 1214 (95.3%)
patients, while 60 (4.7%) had unsuccessful placements. While older
patients were more likely to experience unsuccessful placements, there
were no significant differences in other baseline characteristics.
Unsuccessful placements were attributed to failure in venipuncture or 7
Fr sheath insertion (n = 49) and failure to advance the CS catheter
through the vein (n = 11). No major complications were reported.
Conclusions: CS catheter placement via the right cubital vein
was generally safe with few adverse events and a success rate of
approximately 95%. This approach offers a practical alternative for
placing CS catheters, particularly in patients with adequate vein
development.