Real-time integration of intracardiac echocardiography and 3D electroanatomical mapping to guide catheter ablation of isthmus-dependent atrial flutter in a patient with complete situs inversus and interruption of the inferior vena cava with azygos continuation
Tóm tắt
Atrial tachycardias are relatively common in patients with congenital heart disease. However, complex anomalies involving the heart and the great vessels might compromise the results of the ablation procedure. This report describes a clinical application of the new Cartosound™ module as an adjunctive technology to understand the mechanism of the arrhythmia and to guide successfully the ablation in a complex anatomy. Isthmus-dependent atrial flutter was diagnosed in a patient with complete situs inversus and interruption of the inferior vena cava with azygos continuation. Under these unusual circumstances, Cartosound facilitates interventional navigation within the right atrium and its adjacent structures and minimizes radiation exposure.
Tài liệu tham khảo
Da Costa, A., The’venin, J., Roche, F., Romeyer-Bouchard, C., Abdellaoui, L., Messier, M., et al. (2006). Results from the Loire-Ardèche-Drôme-Isère-Puy-de-Dôme (LADIP) trial on atrial flutter, a multicentric prospective randomized trial comparing amiodarone and radiofrequency ablation after the first episode of symptomatic atrial flutter. Circulation, 114, 1676–1681.
Natale, A., Newby, K. H., Pisano, E., Leonelli, F., Fanelli, R., Potenza, D., et al. (2000). Prospective randomized comparison of anti arrhythmic therapy versus first line radiofrequency ablation in patients with atrial flutter. Journal of the American College of Cardiology, 35, 1898–1904.
Feltes, T. F., & Friedman, R. A. (1994). Transesophageal echocardiographic detection of atrial thrombi in patients with non fibrillation atrial tachyarrhythmias and congenital heart disease. Journal of the American College of Cardiology, 24, 1365–1370.
Triedman, J. K., Alexander, M. A., Love, B. A., Collins, K. K., Berul, C. I., Bevilacqua, L. M., et al. (2002). Influence of patient factors and ablative technologies on outcomes of radiofrequency ablation of intra-atrial tachycardia in patients with congenital heart disease. Journal of the American College of Cardiology, 39, 1827–1835.
Kistler, P. M., Roberts-Thomson, K. C., Haqqani, H. M., Fynn, S. P., Singarayar, S., Vohra, J. K., et al. (2006). P-wave morphology in focal atrial tachycardia: development of an algorithm to predict the anatomic site of origin. Journal of the American College of Cardiology, 48, 1010–1017.