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ABSTRACT: A 49-year-old woman with dextrocardia and situs inversus underwent catheter ablation of paroxysmal atrial fibrillation (AF). During the electrophysiologic study, AF triggered by frequent premature atrial contractions (PACs) with a short coupling interval exhibiting a "P on T" pattern occurred. Pulmonary vein mapping revealed that those PACs originated from right-sided (anatomic left) or left-sided (anatomic right) pulmonary veins. In this case with mirror-image dextrocardia, the P-wave morphologies in leads I and aVL and the II/III ratio of the P-wave amplitude were helpful for predicting a right- or left-sided pulmonary vein origin.
Annals of Noninvasive Electrocardiology 08/2009; 14(3):301-4. · 1.10 Impact Factor
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ABSTRACT: A 79-year-old woman without structural heart disease underwent catheter ablation of ventricular tachycardia. Successful ablation was achieved on the left ventricular epicardium using an epicardial approach via pericardial puncture. Thereafter, programmed stimulation induced ventricular fibrillation (VF). A 360 J biphasic extrathoracic cardioversion using cutaneous pads in the conventional sternal-apical position failed to terminate the VF. After repositioning the sternal pad more laterally, the 360 J biphasic shock terminated the VF. Fluoroscopic imaging revealed aspirated air in the pericardial space, mainly apically. In this case, air aspirated into the pericardial space during the epicardial approach might have elevated the defibrillation threshold.
International journal of cardiology 07/2008; 135(1):e34-5. · 7.08 Impact Factor
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ABSTRACT: A 49-year-old woman with dextrocardia and situs inversus underwent catheter ablation of paroxysmal atrial fibrillation. A contrast injection into the left atrium revealed that the left atrial appendage (LAA) was adjacent to the right-sided (anatomic left) superior pulmonary vein (PV). After successful isolation of that PV, LAA potentials were recorded from several electrode pairs of a circular PV mapping catheter. LAA may cause similar difficulties during PVI of the right-sided superior PV in a dextrocardia patient, as during PVI of the left superior PV in a normal heart.
Europace 07/2008; 10(9):1120-2. · 1.98 Impact Factor
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Circulation Arrhythmia and Electrophysiology 06/2008; 1(2):140-2. · 6.46 Impact Factor
