Atrial fibrillation and atrial flutter ablation using mirror image in a patient with dextrocardia and situs inversus

Ulus, Taner; Dural, Muhammet; Şener, Emre; Al, Aytuğ; Mert, Kadir Uğur; Görenek, Bülent

doi:10.14744/anatoljcardiol.2020.20766

Cited by 7 publications

(7 citation statements)

References 6 publications

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“…There are few case reports demonstrated that patients with DSI accompanied with AF have undergone successful PVI using manual cryoballoon [ 4 ], hotballoon [ 5 ], and manual-guided RF ablation [ 6 , 7 ]. However, catheter and long sheath manipulations in manual-guided ablation are complex in cases of heart inversion, making it more difficult to achieve good catheter-to-tissue contact during PVI, especially in the left atrial ridge area [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Robotic magnetic navigation-guided pulmonary vein isolation in an atrial fibrillation patient with dextrocardia situs inversus: techniques and potential advantages

Luo

Xie

et al. 2023

BMC Cardiovasc Disord

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Background Dextrocardia with situs inversus (DSI) is a very rare congenital anomaly. Catheter manipulation and ablation of atrial fibrillation (AF) in patients with this anatomical variant is challenging for the operators. This case report presents a safe and effective AF ablation guided by the robotic magnetic navigation (RMN) system in combination with intracardiac echocardiograhy (ICE) in a patient with DSI. Case presentation A 64-year-old male with DSI was referred for catheter ablation of symptomatic, drug-refractory paroxysmal AF. One transseptal access was achieved via the left femoral vein under the guidance of ICE. The three-dimensional reconstruction of the left atrium and the pulmonary veins (PVs) were performed by the magnetic catheter using the CARTO and the RMN system. Then, the electroanatomic map and pre-acquired CT images were merged. Finally, bilateral circumferential ablation lines were delivered around the ipsilateral PV ostia to achieve complete PV isolation (PVI). Conclusions This case demonstrates that AF catheter ablation under the guidance of the RMN system using ICE is feasible and safe in a patient with DSI. Moreover, the combination of these technologies broadly facilitates treatment of patients with complex anatomy, while reducing the risk of complications.

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Section: Discussionmentioning

confidence: 99%

Robotic magnetic navigation-guided pulmonary vein isolation in an atrial fibrillation patient with dextrocardia situs inversus: techniques and potential advantages

Luo

Xie

et al. 2023

BMC Cardiovasc Disord

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“…Carter et al reported using radiofrequency ablation to terminate atrial flutter in a patient with dextrocardia [ 15 ]. Atrial fibrillation and atrial flutter can occur concurrently, as in the case of a 50-year-old male reported by Ulus et al, which presented as dextrocardia with associated situs inversus [ 16 ]. Ablation for both atrial fibrillation and atrial flutter successfully converted such arrhythmias to a sinus rhythm [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Right Heart and Wrong Rhythm: Atrial Flutter in Dextrocardia

Lim,

Bais,

Ali

et al. 2023

Cureus

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Atrial flutter is characterized by rapid atrial activity, causing an abnormal heart rhythm. Recognition and prompt management are of utmost importance since this cardiac arrhythmia could increase the risk of thromboembolic stroke and atrial fibrillation, which may lead to disability and death. Risk factors include myocardial infarction, surgery, medication, and structural heart abnormalities. One distinctive structural abnormality is dextrocardia. Herein, we present a case of a 47-year-old male who initially complains of difficulty in ambulation. Further workup showed atrial flutter with rapid ventricular response on electrocardiogram (ECG) and dextrocardia on imaging. This case tackles the possible association between dextrocardia and arrhythmias, which was an atrial flutter, its management, and treatment outcomes.

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“…Routine visualization includes echocardiography, cardiac CT, and 3D mapping. For situs solitus and situs inversus without an additional abnormal anatomy, adjusting for projection angulation and catheter manipulation provides an efficient solution to achieve successful catheter ablation 25,26 . For patients with a complicated anatomy, management entails routine visualization and 3D reconstruction to comprehend the distorted cardiac structure and guide the positioning of the catheter which eventually reduces the procedural duration, minimizes risks of complications from the procedure, and facilitates acute success.…”

Section: Discussionmentioning

confidence: 99%

Result and technique consideration of radiofrequency catheter ablation of tachycardia in patients with dextrocardia

Zhang

Sun

Luo

et al. 2022

Pacing Clinical Electrophis

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Background: Patients with tachycardia, in the context of pre-existing dextrocardia, could benefit from catheter ablation. However, anatomical complexities hinder effective conduct of this procedure. We aimed to retrospectively summarize the clinical characteristics and the safety and efficiency, and recommended the technique considerations.Methods: Twenty-one cases from 19 patients with tachycardia and dextrocardia, who underwent catheter ablation between 2009 and 2021, were enrolled. All patients underwent echocardiography and computed tomography (CT) to confirm the anatomical malformations. Transseptal puncture was guided by fluoroscopy or intracardiac echocardiography when left atrial access was necessary and the ablation process was guided by three-dimensional (3D) mapping.Results: Six cases exhibited situs solitus while nine cases exhibited situs inversus. Fourteen cases had atrial fibrillation, seven had atrial flutter, and two had atrioventricular reentrant tachycardia (AVRT); two cases had combined atrial fibrillation and atrial flutter. Acute success was achieved in 18 cases (85.7%, 18/21). The 3D mapping system was not employed in the three cases which failed. During long-term follow-up (20.71 ± 21.86 months), eight cases (72.7%, 8/11) of atrial fibrillation with dextrocardia successfully attained sinus rhythm. None of AVRT cases had recurrence. Half of the atrial flutter cases with dextrocardia, especially those with a history of surgical correction for cardiac malformations, underwent recurrence. One case had cardiac tamponade. Conclusions:Catheter ablation for tachycardia patients with dextrocardia is safe, efficient, and feasible. It is imperative to integrate echocardiography, cardiac computer tomography, and 3D mapping, and apply 3D reconstruction to facilitate the success of catheter ablation.

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Atrial fibrillation and atrial flutter ablation using mirror image in a patient with dextrocardia and situs inversus

Cited by 7 publications

References 6 publications

Robotic magnetic navigation-guided pulmonary vein isolation in an atrial fibrillation patient with dextrocardia situs inversus: techniques and potential advantages

Robotic magnetic navigation-guided pulmonary vein isolation in an atrial fibrillation patient with dextrocardia situs inversus: techniques and potential advantages

Right Heart and Wrong Rhythm: Atrial Flutter in Dextrocardia

Result and technique consideration of radiofrequency catheter ablation of tachycardia in patients with dextrocardia

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