JACC. Case reports · 2026
Radiofrequency Ablation for Typical Atrial Flutter in Dextroversion With PLSVC and IVC Interruption.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Zheng Hongmei, Pei Chongzhe, Li Dong, Li Hongshi, Xue Li, Cai Heng
Аннотация
BACKGROUND: Congenital interruptions of the inferior vena cava (IVC) and persistent left superior vena cava (PLSVC) are rare. When combined with dextroversion, they pose significant challenges for catheter ablation.
CASE SUMMARY: A 65-year-old man with 2-year palpitations (worsened for half a month) had typical atrial flutter and dextroversion on ECG. Echocardiography showed PLSVC; computed tomography angiography confirmed IVC interruption. Ablation was successfully performed via a left superior venous approach with 3D mapping, targeting the cavotricuspid isthmus between the tricuspid annulus and hepatic vein.
DISCUSSION: This is the first reported case of atrial flutter ablation in a patient with coexisting dextroversion, PLSVC, and IVC interruption. It highlights the importance of anatomical recognition and adaptive strategies.
TAKE-HOME MESSAGES: Preprocedural imaging is crucial in cardiac malformation. Alternative access routes and 3D mapping are key to successful ablation in complex anatomy.
CASE SUMMARY: A 65-year-old man with 2-year palpitations (worsened for half a month) had typical atrial flutter and dextroversion on ECG. Echocardiography showed PLSVC; computed tomography angiography confirmed IVC interruption. Ablation was successfully performed via a left superior venous approach with 3D mapping, targeting the cavotricuspid isthmus between the tricuspid annulus and hepatic vein.
DISCUSSION: This is the first reported case of atrial flutter ablation in a patient with coexisting dextroversion, PLSVC, and IVC interruption. It highlights the importance of anatomical recognition and adaptive strategies.
TAKE-HOME MESSAGES: Preprocedural imaging is crucial in cardiac malformation. Alternative access routes and 3D mapping are key to successful ablation in complex anatomy.