scholarly journals Percutaneous transhepatic access for catheter ablation of A patient with heterotaxy syndrome complicated with atrial fibrillation ：a case report

2021 ◽  
Author(s):  
Na Li ◽  
Haixiong Wang ◽  
xue Han ◽  
jian An
Keyword(s):  
Atrial Fibrillation ◽  
Case Report ◽  
Catheter Ablation ◽  
Inferior Vena ◽  
Femoral Vein ◽  
Vena Cava ◽  
Heterotaxy Syndrome ◽  
Surgical Ligation ◽  
Vein Access ◽  
Transhepatic Access

Atrial fibrillation (AF) is one of the most common arrhythmia, and radiofrequence catheter ablation has become the most effective treatment method.The inferior vena cava(IVC)is a common approach for radiofrequency ablation of atrial fibrillation. In some cases, this approach cannot be used, such as chronic venous occlusions, surgical ligation of the IVC and heterotaxy syndrome. In patients without femoral vein access, use of the hepatic vein for PVI is a viable alternative for invasive EP procedures.

scholarly journals Radiofrequency ablation for paroxysmal atrial fibrillation in a patient with dextrocardia and interruption of the inferior vena cava: a case report

2021 ◽  
Vol 5 (5) ◽  
Author(s):  
Xiaofeng Hu ◽  
Shaohui Wu ◽  
Mu Qin ◽  
Weifeng Jiang ◽  
Xu Liu
Keyword(s):  
Atrial Fibrillation ◽  
Case Report ◽  
Inferior Vena Cava ◽  
High Power ◽  
Inferior Vena ◽  
Femoral Vein ◽  
Vena Cava ◽  
Transseptal Puncture ◽  
Rf Ablation ◽  
Anatomical Variant

Abstract Background Dextrocardia with interruption of the inferior vena cava (I-IVC) is a very rare anatomical variant. Catheter ablation of atrial fibrillation (AF) in patients with this anatomical variant is challenging for electrophysiologists. This case report presents a safe, effective, and radiation-free approach for high-power ablation of AF via a superior transseptal approach in patients with dextrocardia and I-IVC. Case summary A 57-year-old man with paroxysmal AF with dextrocardia and I-IVC with azygos continuation was referred to our hospital for radiofrequency (RF) ablation. It was evident that transseptal puncture and pulmonary vein isolation (PVI) would be impossible using an IVC approach via the femoral vein. Therefore, we decided to perform left atrium (LA) ablation via the superior vena cava approach. A phased array intracardiac echocardiography (ICE) catheter was inserted in the right femoral vein. Three-dimensional (3D) anatomical reconstruction of LA, right atrium (RA), and coronary sinus (CS) ostium were performed using ICE with azygos vein and RA imaging. Navigation-enabled electrodes were inserted into annotated CS on cardiac 3D ICE image. The left internal jugular vein was accessed using an SL1 transseptal sheath and Brockenbrough needle. Transseptal puncture was performed under ICE with an RF-assisted approach. We accomplished ablation index guided high-power pulmonary vein isolation using a bi-directional guiding sheath with visualization capabilities and a surround flow contact force-sensing catheter. No complications occurred during or after the procedure. Discussion With the application of multitude of newer technologies, we can accomplish safe, effective, and fluoroscopy-free RF ablation of AF using the superior approach in patients with complex anomaly.

Catheter ablation of atrial fibrillation via superior approach in patients with interruption of the inferior vena cava

Heart Rhythm ◽  
2009 ◽  
Vol 6 (2) ◽  
pp. 174-179 ◽  
Author(s):  
Hong Euy Lim ◽  
Hui-Nam Pak ◽  
Hung-Fat Tse ◽  
Chu-Pak Lau ◽  
Chun Hwang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Superior Approach

scholarly journals Modified Mini-Maze for Atrial Fibrillation with Interruption of Inferior Vena Cava

2021 ◽  
Vol 24 (6) ◽  
pp. E1046-E1048
Author(s):  
Bijun Xu ◽  
Fan He ◽  
Shiqiang Wang ◽  
Huaidong Chen ◽  
Weimin Zhang
Keyword(s):  
Atrial Fibrillation ◽  
Inferior Vena Cava ◽  
Left Atrium ◽  
Inferior Vena ◽  
Thoracoscopic Surgery ◽  
Femoral Vein ◽  
Vena Cava ◽  
Maze Procedure ◽  
Cardiac Ganglia ◽  
Video Assisted Thoracoscopic Surgery

A 57-year-old female with paroxysmal atrial fibrillation and an interrupted inferior vena cava (IVC) was referred to our hospital for radiofrequency ablation. Transseptal puncture and left atrium ablation failed through a standard IVC approach via the femoral vein due to intrahepatic interruption of IVC. We performed a modified mini-maze procedure in this patient through the left thoracic cavity under video-assisted thoracoscopic surgery (VATS). We can successfully complete pulmonary vein (PV) isolation, left atrium box isolation, cardiac ganglia ablation, Marshall ligament ablation, and coronary sinus epicardium ablation using this technique.

scholarly journals P1732 Congenital absence of the inferior vena cava: challenge for catheter ablation of arrhythmias via the femoral vein approach

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
R S Prisecaru ◽  
C Leatu ◽  
O Purcar ◽  
C Pitis ◽  
V Costache
Keyword(s):  
Catheter Ablation ◽  
Inferior Vena Cava ◽  
Left Atrium ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Inferior Vena ◽  
Femoral Vein ◽  
Vena Cava ◽  
Congenital Absence ◽  
Congenital Cardiac Anomalies

Abstract Introduction Congenital anomalies of the inferior vena cava (IVC) are a well described entity. These anomalies include complete absence, partial absence or duplication of the IVC. They are seen more frequently in those with other congenital cardiac anomalies (0.6%–2%). This congenital condition can be discovered incidentally, or due to symptoms of associated congenital heart disease, asplenia, polysplenia, congenital kidney anomalies or deep venous thrombosis. Case report We report the case of a 48 years old man scheduled for pulmonary vein isolation due to persistent atrial fibrillation resistant to antiarhythmic drugs, symptomatic for palpitations and dyspnea on exertion. Transthoracic ecgocardiography showed mild left atrium enlargement, normal systolic LV function and no significant valve disease. The transoesophageal echocardiography revealed dilation of the left atrium and absence of thrombus in the left atrium or left appendage. Multi-slice spiral thoracic computed tomography (MSCT) was also performed before the procedure and revealed absence of the inferior vena cava and significant dilation of the azygos and hemiazygos veins with subsequent drainage into the superior vena cava. Abdominal CT showed also partial situs inversus. Pulmonary vein isolation (PVI) through femoral vein approach was cancelled and the patient was scheduled for remote magnetic navigation PVI through arterial approach. Conclusions Whether the absence of the IVC is an embryonic anomaly or the result of perinatal thrombosis with regression and subsequent congenital absence of the IVC, absence of the IVC creates difficulties for catheter ablation of arrhythmias via the femoral vein approach.

scholarly journals An uncommon case of inferior vena cava injury during atrial fibrillation ablation

2020 ◽  
Vol 2020 (8) ◽  
Author(s):  
Manuela Pastoricchio ◽  
Andrea Dell’Antonio ◽  
Massimo Zecchin ◽  
Elisabetta Bianco ◽  
Annalisa Zucca ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Abdominal Pain ◽  
Catheter Ablation ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Open Repair ◽  
Vena Cava ◽  
Intracardiac Echocardiography ◽  
Uncommon Case ◽  
The Right

Abstract A 64-year-old man underwent catheter ablation (CA) of atrial fibrillation with intracardiac echocardiography (ICE) assistance. As the probe was advanced toward the right atrium, sudden abdominal pain was felt by the patient with hypotension and tachycardia requiring fluids and vasopressors for hemodynamic stabilization. The inferior vena cava (IVC) was injured by the passing probe and open repair was then performed. To our knowledge, this is the first reported case of symptomatic IVC laceration by the probe used for ICE during CA.

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