Pulmonary Vein Isolation for Treatment of Paroxysmal Atrial Fibrillation on Patient with Situs Inversus Totalis

Abstract

A 56-year-old male with paroxysmal atrial fibrillation refractory to class IC and class III antiarrhythmic drugs was admitted to our hospital for radiofrequency catheter ablation of atrial fibrillation. During preoperative examination situs inversus totalis was revealed. Pulmonary vein (PV) isolation was successfully performed with atrial fibrillation termination and elimination of all PV potentials. The procedure was performed without any complications. Our report shows that PV isolation for treatment of drug-refractory atrial fibrillation can be safely performed in patients with dextrocardia and situs inversus totalis.

HotBalloon ablation of atrial fibrillation in patients with dextrocardia and situs inversus by “mirror image” approach

“…The frequency of dextrocardia with situs inversus was reported as 1–2/20000 in the general population, and successful PVI for these patients has been achieved by radiofrequency catheter ablation in a few reports . Recently, Yoshiga et al reported a case of cryoballoon ablation in patients with paroxysmal AF with dextrocardia and situs inversus.…”

“…Pulmonary vein isolation (PVI) for atrial fibrillation (AF) in patients with dextrocardia is challenging. A few reports have demonstrated successful PVI in patients with dextrocardia and situs inversus using radiofrequency ablation or cryoballoon ablation . The HotBalloon technique has also been established as a simple technique for PVI for AF .…”

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

“…The orientation of fluoroscopic image may be confusing in patients with dextrocardia. Previous studies have reported cases of successful PV isolation with CB or radiofrequency ablation in patients with dextrocardia with situs inversus ( 1 - 3 , 6 ). In these cases, ICE was used to assist TS puncture and PV isolation.…”

“…The use of ICE, particularly in patients with a complex anatomy, facilitates the procedure and reduces the risk of complications ( 1 - 3 ). Three-dimensional mapping systems in combination with ICE have also been employed to assist PV isolation ( 1 - 3 , 6 ).…”

Ablacja drogi wolnej węzła przedsionkowo-komorowego u pacjenta z napadowymi częstoskurczami i situs inversus z użyciem systemu elektroanatomicznego 3D Carto

“…W dostępnej literaturze istnieje jedynie kilka opisów przypadków ablacji częstoskurczów AV nawrotnych i AV węzłowych nawrotnych u pacjentów z tą wadą anatomiczną [2,3]. Istnieją także doniesienia izolacji energią RF żył płucnych u pacjentów z dekstrokardią przy użyciu systemu elektroanatomicznego 3D [4]. W przedstawianych opisach przypadków raportowano długi czas fluoroskopii będący wynikiem odwróconej anatomii lub innych towarzyszących wad anatomicznych serca.…”