Using Open-Window Mapping Strategy for Wolff-Parkinson-White Syndrome in a Patient With Dextrocardia With Situs Inversus.

The coexistence of dextrocardia and Wolff-Parkinson-White (WPW) syndrome is exceedingly rare and presents unique challenges for electrophysiological mapping and ablation. We report the first successful radiofrequency catheter ablation guided by three-dimensional open-window mapping (OWM) in such a patient. Pre-procedural right-sided electrocardiography analyzed with the EASY-WPW algorithm predicted a right inferoparaseptal accessory pathway, consistent with OWM localization. Despite reversed cardiac anatomy, precise mapping enabled effective ablation without complications. This case illustrates the feasibility of three-dimensional OWM-guided ablation in complex anatomic variants and highlights the complementary role of the EASY-WPW algorithm in accurately predicting accessory pathway locations before intervention.