Key result
Catheter ablation was successfully performed in a patient with dextrocardia, where the left atrial appendage caused mapping difficulties during isolation of the right-sided superior pulmonary vein.
Case Report (n=1)
Highlights the anatomical considerations and potential mapping difficulties involving the left atrial appendage during pulmonary vein isolation in patients with dextrocardia.
Supports feasibility in dextrocardia despite anatomy; leaves open generalizability and need for larger studies.
A 49-year-old woman with dextrocardia and situs inversus underwent catheter ablation of paroxysmal atrial fibrillation. A contrast injection into the left atrium revealed that the left atrial appendage (LAA) was adjacent to the right-sided (anatomic left) superior pulmonary vein (PV). After successful isolation of that PV, LAA potentials were recorded from several electrode pairs of a circular PV mapping catheter. LAA may cause similar difficulties during PVI of the right-sided superior PV in a dextrocardia patient, as during PVI of the left superior PV in a normal heart.
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Yamada et al. (2008) conducted a case report in Paroxysmal atrial fibrillation with dextrocardia and situs inversus (n=1). Catheter ablation was evaluated. Catheter ablation was successfully performed in a patient with dextrocardia, where the left atrial appendage caused mapping difficulties during isolation of the right-sided superior pulmonary vein.
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