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.