Catheter ablation of typical atrial flutter with the superior approach in a patient with inferior vena cava interruption

Traykov, Vassil; Marchov, D; Kirova, Galina; Гелев, Валери

doi:10.1002/ccr3.1196

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…This is necessary if several segments of IVC are missing and femoral access is not possible. 2 Also conceivable is venous access via the jugular vein. In the few previously published case reports of similar anatomic conditions with ablation procedures owing to typical atrial flutter, no high-density mapping was used, but predominantly conventional fluoroscopic approach was employed.…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency ablation of typical atrial flutter with access through the azygos vein in a patient with heterotopia utilizing high-density electroanatomic mapping

Borlich

Weinert

Becker

et al. 2018

HeartRhythm Case Reports

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Section: Discussionmentioning

confidence: 99%

Radiofrequency ablation of typical atrial flutter with access through the azygos vein in a patient with heterotopia utilizing high-density electroanatomic mapping

Borlich

Weinert

Becker

et al. 2018

HeartRhythm Case Reports

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“…Amongst 22 patients undergoing ablation of the cavo‐tricuspid isthmus (CTI), superior approach was utilized in 9 patients, inferior approach in 8 patients (Figure 4), trans‐hepatic approach in 4 patients, and the case was abandoned in 1 patient. Achieving adequate contact was frequently cited as an issue regardless of whether a superior or inferior approach was used, 9–11 although the acute angle at the azygous‐SVC junction made catheter manipulation a challenge with the inferior approach 9 . Specific catheter manoeuvres may also improve catheter contact and stability.…”

Section: Approaches To Ablation Of Specific Arrhythmiasmentioning

confidence: 99%

Systematic review of electrophysiology procedures in patients with obstruction of the inferior vena cava

Al-Sinan¹,

Cardiac

Chan

et al. 2022

Cardiovasc electrophysiol

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Aims The objective of the study was to conduct a systematic review to describe and compare the different approaches for performing cardiac electrophysiology (EP) procedures in patients with interrupted inferior vena cava (IVC) or equivalent entities causing IVC obstruction. Methods We conducted a structured search to identify manuscripts reporting EP procedures with interrupted IVC or IVC obstruction of any aetiology published up until August 2020. No restrictions were applied in the search strategy. We also included seven local cases that met inclusion criteria. Results The analysis included 142 patients (mean age 48.9 years; 48% female) undergoing 143 procedures. Obstruction of the IVC was not known before the index procedure in 54% of patients. Congenital interruption of IVC was the most frequent cause (80%); and, associated congenital heart disease (CHD) was observed in 43% of patients in this setting. The superior approach for ablation was the most frequently used strategy (52%), followed by inferior approach via the azygos or hemiazygos vein (24%), transhepatic approach (14%), and retroaortic approach (10%). Electroanatomical mapping (58%), use of long sheaths (41%), intracardiac echocardiography (19%), transesophageal echocardiography (15%) and remote controlled magnetic navigation (13%) were used as adjuncts to aid performance. Ablation was successful in 135 of 140 procedures in which outcomes were reported. Major complications were only reported in patients undergoing AF ablation, including two patients with pericardial effusion, one of whom required surgical repair, and another patient who died after inadvertent entry into an undiagnosed atrioesophageal fistula from a previous procedure. Conclusion The superior approach is most frequent approach for performing EP procedures in the setting of obstructed IVC. Transhepatic approach is a feasible alternative, and may provide a “familiar approach” for transseptal access when it is required. Adjunctive use of long sheaths, intravascular echocardiography, electro‐anatomical mapping and remote magnetic navigation may be helpful, especially if there is associated complex CHD. With careful planning, EP procedures can usually be successfully performed with a low risk of complications.

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Successful flutter catheter ablation through the azygos continuation due to an interrupted inferior vena cava

Fagouri,

Ben El Makki,

Outahyou

et al. 2024

Radiology Case Reports

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Catheter ablation of typical atrial flutter with the superior approach in a patient with inferior vena cava interruption

Cited by 3 publications

References 5 publications

Radiofrequency ablation of typical atrial flutter with access through the azygos vein in a patient with heterotopia utilizing high-density electroanatomic mapping

Radiofrequency ablation of typical atrial flutter with access through the azygos vein in a patient with heterotopia utilizing high-density electroanatomic mapping

Systematic review of electrophysiology procedures in patients with obstruction of the inferior vena cava

Successful flutter catheter ablation through the azygos continuation due to an interrupted inferior vena cava

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