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Case Reports
. 2023 Dec;34(12):2621-2625.
doi: 10.1111/jce.16136. Epub 2023 Nov 21.

Radiofrequency ablation of persistent atrial fibrillation in a patient with situs inversus totalis and interrupted inferior vena cava

Fengwei Zou  1 , David Flomenbaum  1 , Nilarun Chowdhuri  1 , Vito Grupposo  2 , Luigi Di Biase  1 , Xiaodong Zhang  1
Affiliations
Case Reports

Radiofrequency ablation of persistent atrial fibrillation in a patient with situs inversus totalis and interrupted inferior vena cava

Fengwei Zou et al. J Cardiovasc Electrophysiol. 2023 Dec.

Abstract

Introduction: Catheter ablation of atrial fibrillation (AF) has emerged as the most effective therapy. However, rare anatomical abnormalities such as situs inversus totalis, dextrocardia, or interrupted inferior vena cava can make ablation challenging.

Methods and results: We report a case of a 55-year-old woman with situs inversus totalis, dextrocardia, surgical atrial septal defect repair, left-sided dual chamber pacemaker in place, and symptomatic recurrent persistent AF who underwent successful pulmonary vein and posterior wall isolation by the superior access from the left internal jugular vein.

Conclusions: It is a feasible and safe approach with support of transesophageal echocardiography and multiple emerging technologies.

Keywords: atrial fibrillation; dextrocardia; interrupted inferior vena cava; radiofrequency ablation; situs inversus totalis.

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References

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