Pulmonary Vein Isolation and Pacemaker Implantation in a Patient with Dextrocardia Situs Inversus

Abstract

A 70-year-old female with dextrocardia with situs inversus (DSI) totalis and inferior vena cava occlusion underwent radiofrequency catheter ablation because she had symptomatic paroxysmal atrial fibrillation (AF). Careful preoperative examination made successful pulmonary vein isolation through the left jugular vein approach. One-year later, however, AF recurred, and symptomatic sinus bradycardia or junctional bradycardia often occurred. Then, the pacemaker was implanted. We here reported a rare case of congenital abnormality, DSI with inferior vena cava occlusion who had undergone successful pulmonary vein isolation and pacemaker implantation without any complications.

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

“…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 ].…”