RF catheter ablation of AVNRT in a patient with interrupted inferior vena cava anomaly with hemiazygos continuity with persistent left superior vena cava

Abstract

Intrahepatic interruption of the inferior vena cava (IVC) with continued hemizygous is a very rare abnormality and sometimes it may be accompanied by other cardiovascular abnormalities. Continuation of the hemizygous vein draining into the right atrium through the left superior vena cava (LSVC) is much rarer. In this paper, we have presented a patient who had simultaneous IVC interrupted with persistent LSVC and suffered from Atrioventricular nodal reentrant tachycardia (AVNRT). Finally, radiofrequencies (RF) catheter ablation for AVNRT was successfully performed through a left subclavian vein access.

Keywords: AVNRT; IVC interrupted; Persistent LSVC; RF ablation.

Fig. 1

Narrow QRS complex tachycardia in favor of AVNRT

Fig. 2

ECG of normal sinus rhythm

Fig. 3

Chest and Abdominal MDCTA in favor of IVC interrupted

Fig. 4

Atrial stimulation and easily inducible AVNRT

Fig. 5

Position of catheters during mapping and RF ablation

Fig. 6

Junctional rhythm during successful application of RF at the slow pathway site Video 1. A ablation catheter was positioned in the right side His bundle to recognize His area and then repositioned in slow pathway area through a left subclavian vein access