Successful Radiofrequency Catheter Ablation of Atrioventricular Nodal Reentrant Tachycardia in a Patient with Dextrocardia and Situs Invertus

Yoshiyasu Aizawa, Shunichiro Miyoshi, Takehiro Kimura, Nobuhiro Nishiyama, Kotaro Fukumoto, Yukiko Fukuda, Toshiaki Sato, Seiji Takatsuki, Keiichi Fukuda

Research output: Contribution to journalArticle

Abstract

Experience of radiofrequency catheter ablation (RFCA) in patients with dextrocardia and sinus invertus is limited for its extremely rare incidence. A 21-year-old male with recurrent episodes of supraventricular tachycardia was referred to our hospital for the electrophysiological study (EPS). He had received operation for double outlet right ventricle with ventricular septal defect at his age of 9 months. Twelve lead ECG, echocardiography and computed tomography showed dextrocardia with situs invertus. At EPS, electrode catheters were positioned at the right atrial appendage, His bundle - right ventricular apex and the coronary sinus as completely mirror image. Programmed electrical stimulation induced typical atrioventricular nodal reentrant tachycardia (AVNRT). A 3.5 mm tip sarine-irrigated ablation catheter was required to successful ablation of slow pathway (SP), which was not located at usual Koch's triangle region but at rightward position, and the tachycardia became non-inducible. This suggests SP might have located at the right side of atrial septum, despite completely mirror image. The CARTO-XP (Biosense Webster) was useful for determine the intracardiac orientation. This is a unique case of AVNRT in a patient with mirror-image dextrocardia. We could successfully treated AVNRT by sarine-irrigated RFCA. Exact anatomical evaluation using electro-anatomical mapping is critical in such a case with cardiac anomaly.

Original languageEnglish
JournalJournal of Arrhythmia
Volume27
DOIs
Publication statusPublished - 2011

Fingerprint

Dextrocardia
Atrioventricular Nodal Reentry Tachycardia
Catheter Ablation
Double Outlet Right Ventricle
Atrial Septum
Bundle of His
Atrial Appendage
Supraventricular Tachycardia
Coronary Sinus
Ventricular Heart Septal Defects
Tachycardia
Electric Stimulation
Echocardiography
Electrocardiography
Electrodes
Catheters
Tomography
Incidence

Keywords

  • catheter ablation
  • dextrocardia
  • tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Successful Radiofrequency Catheter Ablation of Atrioventricular Nodal Reentrant Tachycardia in a Patient with Dextrocardia and Situs Invertus. / Aizawa, Yoshiyasu; Miyoshi, Shunichiro; Kimura, Takehiro; Nishiyama, Nobuhiro; Fukumoto, Kotaro; Fukuda, Yukiko; Sato, Toshiaki; Takatsuki, Seiji; Fukuda, Keiichi.

In: Journal of Arrhythmia, Vol. 27, 2011.

Research output: Contribution to journalArticle

Aizawa, Yoshiyasu ; Miyoshi, Shunichiro ; Kimura, Takehiro ; Nishiyama, Nobuhiro ; Fukumoto, Kotaro ; Fukuda, Yukiko ; Sato, Toshiaki ; Takatsuki, Seiji ; Fukuda, Keiichi. / Successful Radiofrequency Catheter Ablation of Atrioventricular Nodal Reentrant Tachycardia in a Patient with Dextrocardia and Situs Invertus. In: Journal of Arrhythmia. 2011 ; Vol. 27.
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abstract = "Experience of radiofrequency catheter ablation (RFCA) in patients with dextrocardia and sinus invertus is limited for its extremely rare incidence. A 21-year-old male with recurrent episodes of supraventricular tachycardia was referred to our hospital for the electrophysiological study (EPS). He had received operation for double outlet right ventricle with ventricular septal defect at his age of 9 months. Twelve lead ECG, echocardiography and computed tomography showed dextrocardia with situs invertus. At EPS, electrode catheters were positioned at the right atrial appendage, His bundle - right ventricular apex and the coronary sinus as completely mirror image. Programmed electrical stimulation induced typical atrioventricular nodal reentrant tachycardia (AVNRT). A 3.5 mm tip sarine-irrigated ablation catheter was required to successful ablation of slow pathway (SP), which was not located at usual Koch's triangle region but at rightward position, and the tachycardia became non-inducible. This suggests SP might have located at the right side of atrial septum, despite completely mirror image. The CARTO-XP (Biosense Webster) was useful for determine the intracardiac orientation. This is a unique case of AVNRT in a patient with mirror-image dextrocardia. We could successfully treated AVNRT by sarine-irrigated RFCA. Exact anatomical evaluation using electro-anatomical mapping is critical in such a case with cardiac anomaly.",
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