Introduction
Dextrocardia is a mirror image right-sided heart with congenital heart position malformation associated with abnormal embryonic development, unusual organ position transposition, other internal organs inversion, etc. The incidence is low in the population, only 1/10,000-12,0001. Patients with dextrocardia usually have no specific health problems, but are more likely to suffer from cardiovascular, esophageal, intestinal, and bronchial diseases than the general population2.
Atrial tachycardia is a common type of atrial arrhythmia that originates in the atria and does not require the participation and maintenance of the atrioventricular node. The atrial frequency during atrial tachycardia attacks is mostly 150-200 beats/min3. The incidence of atrial septal aneurysm is about 2.4%4. Previous studies suggest that the incidence of atrial arrhythmias is about 15% in adult patients with congenital heart disease, and the incidence of atrial tachycardia is even lower in patients with dextrocardia and atrial septal aneurysm, which has rarely been reported5. Because of the anatomical abnormalities of the heart and blood vessels in patients with dextrocardia, ablation of arrhythmias is more complex than regular patients, and cannot effectively guarantee safety.
Intracardiac echocardiography (ICE) is an advanced imaging method in electrophysiological procedures. Combined electroanatomical mapping systems can guide catheter ablation in complex anatomical conditions. ICE facilitates the visualization of the evaluation of the catheter positioning, which better assists operator in gaining a comprehensive understanding of the variable cardiac structures and effectively guarantees the safe performance of the procedure6,7.
This article reports a case of successful radiofrequency ablation of atrial tachycardia in a patient with dextrocardia and atrial septal aneurysm in combination with intracardiac echocardiography, and summarizes the relevant experience.