Zero-fluoroscopy radiofrequency ablation was successfully and safely performed in 1 patient with situs inversus totalis and high-burden PVCs using 3D mapping and intracardiac echocardiography.
Case Report (n=1)
Is zero-fluoroscopy radiofrequency ablation feasible and safe for treating refractory PVCs in a patient with situs inversus totalis?
Zero-fluoroscopy PVC radiofrequency ablation using 3D mapping and intracardiac echocardiography is feasible and safe even in patients with complex congenital anomalies like situs inversus totalis.
Background Congenital cardiac anomalies present unique challenges for adult cardiac electrophysiologists, particularly when attempting complex ablation procedures. Case Summary We report the case of a 60‐year‐old male with situs inversus totalis who presented with symptomatic, high‐burden premature ventricular complexes (PVCs) refractory to medical therapy. Using reversed (mirror‐image) precordial lead placement, high‐definition 3D electroanatomic mapping, and intracardiac echocardiography, successful radiofrequency ablation was achieved using a completely zero‐fluoroscopy approach. Discussion In patients with congenital cardiac anomalies, the applicability of zero‐fluoroscopy strategies is often limited because of their complex anatomy. Successful management requires in‐depth anatomical understanding and carefully adapted procedural techniques. This case highlights that even in the setting of significant anatomical variation, a systematic zero‐fluoroscopy approach can lead to effective and safe outcomes. Take‐Home Message Zero‐fluoroscopy PVC radiofrequency ablation using high‐definition 3D mapping and intracardiac echocardiography is a feasible and safe approach, even in anatomically challenging cases such as situs inversus.
Sanhueza et al. (Thu,) conducted a case report in Premature ventricular complexes in situs inversus totalis (n=1). Zero-fluoroscopy radiofrequency ablation was evaluated on Successful radiofrequency ablation. Zero-fluoroscopy radiofrequency ablation was successfully and safely performed in 1 patient with situs inversus totalis and high-burden PVCs using 3D mapping and intracardiac echocardiography.