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Catheter ablation of supraventricular tachycardia in patients with dextrocardia and situs inversus

医学 右位心 倒位 房室折返性心动过速 心动过速 心脏病学 室上性心动过速 导管消融 内科学 烧蚀 房性心动过速 心房扑动 导管 外科 旁道
作者
Gongbu Zhou,Jian Ma,Jinlin Zhang,Xiaogang Guo,Jiandu Yang,Shu‐Wang Liu,Feifan Ouyang
出处
期刊:Journal of Cardiovascular Electrophysiology [Wiley]
卷期号:30 (4): 557-564 被引量:12
标识
DOI:10.1111/jce.13847
摘要

Abstract Background Dextrocardia with situs inversus is a rare cardiac positional anomaly. Catheter ablation procedures performed in this set of patients have not been sufficiently reported. Methods A total of 10 patients with dextrocardia and situs inversus who received catheter ablation for supraventricular tachycardia (SVT) were included from a cohort of over 20 000 cases of catheter ablation for SVT in three centers from 2005 to 2016. All patients underwent electrophysiologic study and catheter ablation of SVT. Ablation targets were selected based on different tachycardia mechanisms with the primary endpoint of noninduction of tachycardia. Results The average age was 32.4 ± 5.6 years. Congenitally corrected transposition of great arteries (TGA) with situs inversus and D‐looping of the ventricles and aorta (congenitally corrected TGA {I,D,D}) was found in four patients, while the other six patients exhibited mirror‐image dextrocardia {I,L,L}. The mechanisms of SVT were atrioventricular nodal reentrant tachycardia in four patients, atrioventricular reentrant tachycardia in three, typical atrial flutter in one, intra‐atrial reentrant tachycardia in one, and focal atrial tachycardia in one. Immediate procedural success was achieved in 9 out of 10 patients with no procedural complications. During a follow‐up period of 6.3 ± 3.5 years on average, all patients remained free from recurrent tachycardia. Conclusions For patients with dextrocardia and situs inversus, catheter ablation of SVT is safe and feasible. Differences in catheter maneuver and fluroscopy projection, along with difficulties in distorted anatomy are major obstacles for successful ablation.
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