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Case Reports
. 2018 Jul 20;34(5):583-585.
doi: 10.1002/joa3.12096. eCollection 2018 Oct.

Trans-aortic pulmonary vein isolation using magnetic navigation system for paroxysmal atrial fibrillation in a patient with dextrocardia, situs inversus, and inferior vena cava continuity with azygos vein

Katsunori Okajima  1 , Tomoyuki Nakanishi  1 , Hirotoshi Ichibori  1 , Takeaki Shirai  1 , Makoto Kadotani  1 , Hiroki Shimizu  1 , Yoshio Onishi  1 , Kohei Yamashiro  2
Affiliations
Case Reports

Trans-aortic pulmonary vein isolation using magnetic navigation system for paroxysmal atrial fibrillation in a patient with dextrocardia, situs inversus, and inferior vena cava continuity with azygos vein

Katsunori Okajima et al. J Arrhythm. .

Abstract

A 51-year-old male with dextrocardia and situs inversus underwent catheter ablation for paroxysmal atrial fibrillation. Because the procedure through the trans-septal approach was impossible due to the inferior vena cava continuity with azygos vein, we performed pulmonary vein isolation using magnetic navigation system through the retrograde trans-aortic approach. Superior and inferior left-sided and superior right-sided pulmonary veins could be isolated which was confirmed by the ablation catheter. The patient was free from atrial fibrillation episode at the 12 months follow-up except only one palpitation episode lasting nearly 12 hours at 9 months after the ablation.

Keywords: ablation; atrial fibrillation; dextrocardia; inferior vena cava continuity with azygos vein; magnetic navigation.

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Figures

Figure 1
Figure 1
Fluoroscopic catheter positioning. ABL, ablation catheter; CS, coronary sinus; Eso, esophageal temperature monitor
Figure 2
Figure 2
Anatomical re‐construction using 3D CT and ablation site. SVC, superior vena cava; Azygos, azygos vein; RA, right atrium; LPV, left‐sided pulmonary vein; RPV, right‐sided pulmonary vein. White triangles indicate the ablation line around the PVs. Collar range of ablation tags was dependent on the RF time
See this image and copyright information in PMC

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