Case reports in cardiology · 2026
Zero-Fluoroscopy Radiofrequency Ablation of a Right Ventricular Outflow Tract PVC in a Patient With Situs Inversus Totalis: When Precision Matters.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Sanhueza Eduardo, Hanson Matthew, Neira Victor, Chacko Sanoj, Enriquez Andres, Oli Roji, Saramago Mariana, Burak Cengiz
Аннотация
BACKGROUND: Congenital cardiac anomalies present unique challenges for adult cardiac electrophysiologists, particularly when attempting complex ablation procedures.
CASE SUMMARY: We report the case of a 60-year-old male with situs inversus totalis who presented with symptomatic, high-burden premature ventricular complexes (PVCs) refractory to medical therapy. Using reversed (mirror-image) precordial lead placement, high-definition 3D electroanatomic mapping, and intracardiac echocardiography, successful radiofrequency ablation was achieved using a completely zero-fluoroscopy approach.
DISCUSSION: In patients with congenital cardiac anomalies, the applicability of zero-fluoroscopy strategies is often limited because of their complex anatomy. Successful management requires in-depth anatomical understanding and carefully adapted procedural techniques. This case highlights that even in the setting of significant anatomical variation, a systematic zero-fluoroscopy approach can lead to effective and safe outcomes.
TAKE‐HOME MESSAGE: Zero-fluoroscopy PVC radiofrequency ablation using high-definition 3D mapping and intracardiac echocardiography is a feasible and safe approach, even in anatomically challenging cases such as situs inversus.
CASE SUMMARY: We report the case of a 60-year-old male with situs inversus totalis who presented with symptomatic, high-burden premature ventricular complexes (PVCs) refractory to medical therapy. Using reversed (mirror-image) precordial lead placement, high-definition 3D electroanatomic mapping, and intracardiac echocardiography, successful radiofrequency ablation was achieved using a completely zero-fluoroscopy approach.
DISCUSSION: In patients with congenital cardiac anomalies, the applicability of zero-fluoroscopy strategies is often limited because of their complex anatomy. Successful management requires in-depth anatomical understanding and carefully adapted procedural techniques. This case highlights that even in the setting of significant anatomical variation, a systematic zero-fluoroscopy approach can lead to effective and safe outcomes.
TAKE‐HOME MESSAGE: Zero-fluoroscopy PVC radiofrequency ablation using high-definition 3D mapping and intracardiac echocardiography is a feasible and safe approach, even in anatomically challenging cases such as situs inversus.