Demonstrates the feasibility of left-sided pulmonary vein isolation guided by tomography and intracardiac ultrasound in a patient with major cardiac rotation post-right pneumonectomy.
May facilitate safe AF ablation in post-pneumonectomy rotation; hypothesis-generating for broader use in distorted anatomy.
Male patient, 76 years old, presented symptomatic paroxysmal AF for almost 2 years. Long submitted to total right pneumonectomy and having a major cardiac rotation. The use of tomography and intracardiac ultrasound were fundamental for a better anatomic comprehension and optimization of the safety procedures for AF ablation in these patients, due to the difficulty in accessing the left atrium and the consequent manipulation of catheters. In this case, electrical signals have not yet been detected in the stumps on the right side, with only the left veins being isolated. This approach constitutes a new approach in this clinical situation, with clinical success in a 3-year follow-up.
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Bertoldi et al. (2021) studied this question.
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