Pulmonary Veins, Posterior Wall, and Non-Pulmonary Vein Trigger Ablation in Persistent Atrial Fibrillation and Dextrocardia.

Persistent atrial fibrillation in patients with dextrocardia presents unique technical challenges due to reversed cardiac anatomy. We report a case of successful catheter ablation in a 68-year-old man with dextrocardia and long-standing persistent atrial fibrillation. Using multimodal imaging and high-density electroanatomic mapping, pulmonary vein isolation, posterior wall isolation, and non-pulmonary vein triggers ablation were performed, restoring stable sinus rhythm. The patient remained arrhythmia-free at 12 months. TAKE-HOME MESSAGE: Atrial fibrillation ablation in patients with dextrocardia requires a tailored approach that incorporates multimodality imaging to navigate complex anatomy safely and effectively.