Key result
Imaging modalities such as three-dimensional electroanatomical mapping and computerized tomography successfully guided optimal catheter access and ablation in two patients with complex cardiac anatomy.
Why the study?
Does advanced imaging guide optimal catheter access for ablation in patients with complex cardiac anatomy?
Case Report (n=2)
Does advanced imaging guide optimal catheter access for ablation in patients with complex cardiac anatomy?
Advanced imaging modalities like 3D electroanatomical mapping and CT are crucial for planning and guiding catheter ablation in patients with complex congenital cardiac anatomy.
May support imaging-guided ablation in complex anatomy; hypothesis-generating and requires prospective validation before clinical adoption.
A 66-year-old man with Kartagener's syndrome, situs inversus totalis, and recurrent supraventricular tachycardia and a 49-year-old man with atrial fibrillation and drug-refractory rapid ventricular rate response were referred for catheter ablation. In the first case, the mirrored anatomy of the right atrium was reconstructed using three-dimensional electroanatomical mapping, which guided successful ablation of a typical atrioventricular nodal reentrant tachycardia. In the second case, computerized tomography showed the presence of left atrial isomerism with interruption of the inferior vena cava and azygous continuation into the superior vena cava, guiding advancement of the ablation catheter for access into the positionally right atrial ablation site. These cases illustrate the role of imaging in patients with unusual anatomy of the cardiac chambers and major blood vessels guiding optimal catheter access for catheter ablation.
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Haegeli et al. (2011) conducted a case report in Complex cardiac anatomy and arrhythmias (supraventricular tachycardia, atrial fibrillation) (n=2). Imaging-guided catheter ablation (3D electroanatomical mapping and CT) was evaluated on Successful catheter access and ablation. Imaging modalities such as three-dimensional electroanatomical mapping and computerized tomography successfully guided optimal catheter access and ablation in two patients with complex cardiac anatomy.
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