Key result
Thoracoscopic ablation and LAA exclusion maintains sinus rhythm at 12 months in situs inversus dextrocardia.
Why the study?
Percutaneous AF ablation is challenging and high risk in patients with situs inversus dextrocardia and interrupted inferior vena cava with azygos continuation due to complex anatomy and lack of case reports.
Case Report (n=1)
May inform AF management in dextrocardia; leaves open efficacy in larger cohorts.
INTRODUCTION: Situs inversus totalis, dextrocardia with interrupted inferior vena cava, and azygos vein continuation concomitant with symptomatic atrial fibrillation requiring ablation. This case was deemed not suitable for percutaneous ablation due to anatomic variations and the lack of case reports in the literature. METHODS AND RESULTS: We performed bilateral thoracoscopic epicardial ablation and epicardial left atrial appendage exclusion. The direct vision allowed for a complete box lesion set with bipolar radiofrequency device. Patient remained in sinus rhythm at the 12-months follow-up. CONCLUSION: Surgical thoracoscopic epicardial ablation is safe and effective also in congenital defects. Multidisciplinary expertise can offer minimally invasive ablation treatments.
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Rosati et al. (2022) conducted a case report in Long-standing persistent atrial fibrillation with situs inversus dextrocardia (n=1). Surgical bilateral thoracoscopic epicardial ablation and left atrial appendage exclusion was evaluated on Maintenance of stable sinus rhythm. Surgical bilateral thoracoscopic epicardial ablation and left atrial appendage exclusion safely restored and maintained stable sinus rhythm at 12-month follow-up in a patient with situs inversus dextrocardia.
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