Key result
Left internal jugular access enables feasible, safe persistent AF ablation in situs inversus with interrupted IVC.
Why the study?
Rare anatomical abnormalities such as situs inversus totalis, dextrocardia, or interrupted inferior vena cava can make catheter ablation of atrial fibrillation challenging.
Is radiofrequency ablation via superior access feasible in a patient with persistent AF and complex anatomical abnormalities including situs inversus totalis and interrupted inferior vena cava?
Case Report (n=1)
Is radiofrequency ablation via superior access feasible in a patient with persistent AF and complex anatomical abnormalities including situs inversus totalis and interrupted inferior vena cava?
Demonstrates the feasibility and safety of catheter ablation for atrial fibrillation via superior access in a patient with complex anatomical abnormalities including situs inversus totalis and interrupted inferior vena cava.
May enable AF ablation via superior access in complex anatomy; hypothesis-generating and requires prospective validation before broader adoption.
INTRODUCTION: Catheter ablation of atrial fibrillation (AF) has emerged as the most effective therapy. However, rare anatomical abnormalities such as situs inversus totalis, dextrocardia, or interrupted inferior vena cava can make ablation challenging. METHODS AND RESULTS: We report a case of a 55-year-old woman with situs inversus totalis, dextrocardia, surgical atrial septal defect repair, left-sided dual chamber pacemaker in place, and symptomatic recurrent persistent AF who underwent successful pulmonary vein and posterior wall isolation by the superior access from the left internal jugular vein. CONCLUSIONS: It is a feasible and safe approach with support of transesophageal echocardiography and multiple emerging technologies.
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Zou et al. (2023) conducted a case report in Persistent atrial fibrillation with situs inversus totalis and interrupted inferior vena cava (n=1). Radiofrequency ablation via superior access from the left internal jugular vein was evaluated on Feasibility and safety of the ablation approach. Radiofrequency ablation of persistent atrial fibrillation via superior access from the left internal jugular vein was feasible and safe in a patient with situs inversus totalis and interrupted IVC.
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