Key result
Successful radiofrequency catheter ablation of a coronary sinus-ventricular accessory connection was achieved using a right cubital vein approach in a patient with dextrocardia and anomalous IVC.
Case Report (n=1)
A right cubital vein approach enables successful radiofrequency catheter ablation of accessory pathways in complex congenital anatomies like dextrocardia with situs inversus and anomalous IVC when femoral access is unsuitable.
Cubital vein access may enable ablation in dextrocardia with anomalous IVC when femoral routes fail; leaves open generalizability beyond this single case.
An anomalous inferior vena cava (IVC) is often associated with patients with dextrocardia. However, radiofrequency catheter ablation in such a case with that combination has not been reported. We encountered a case of Wolff-Parkinson-White syndrome with dextrocardia associated with complete situs inversus and an azygos continuation of the IVC. A steep angulation at the junction of the azygos vein and superior vena cava precluded the precise mapping of the anatomical right cavity with a femoral vein approach. Successful catheter ablation of an accessory connection between the coronary sinus and left ventricle could be achieved with a right cubital vein approach.
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Taniguchi et al. (2005) conducted a case report in Wolff-Parkinson-White syndrome with dextrocardia, complete situs inversus, and anomalous inferior vena cava (n=1). Radiofrequency catheter ablation via right cubital vein approach was evaluated on Successful catheter ablation of an accessory connection. Successful radiofrequency catheter ablation of a coronary sinus-ventricular accessory connection was achieved using a right cubital vein approach in a patient with dextrocardia and anomalous IVC.
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