Clinic for Cardiology, Cardiovascular Center, Zurich, Switzerland.
Europace. 2011 Aug;13(8):1203-5. doi: 10.1093/europace/eur059. Epub 2011 Mar 29.
A 66-year-old man with Kartagener's syndrome, situs inversus totalis, and recurrent supraventricular tachycardia and a 49-year-old man with atrial fibrillation and drug-refractory rapid ventricular rate response were referred for catheter ablation. In the first case, the mirrored anatomy of the right atrium was reconstructed using three-dimensional electroanatomical mapping, which guided successful ablation of a typical atrioventricular nodal reentrant tachycardia. In the second case, computerized tomography showed the presence of left atrial isomerism with interruption of the inferior vena cava and azygous continuation into the superior vena cava, guiding advancement of the ablation catheter for access into the positionally right atrial ablation site. These cases illustrate the role of imaging in patients with unusual anatomy of the cardiac chambers and major blood vessels guiding optimal catheter access for catheter ablation.
一位 66 岁的男性患有卡塔格内综合征、全内脏反位和复发性室上性心动过速，另一位 49 岁的男性患有心房颤动和药物难治性快速心室率反应，他们均被转介进行导管消融治疗。在第一个病例中，使用三维电生理标测重建了右心房的镜像解剖结构，指导成功消融了典型的房室结折返性心动过速。在第二个病例中，计算机断层扫描显示存在左心房异构，下腔静脉中断，奇静脉延续至上腔静脉，引导消融导管进入位置正确的右心房消融部位。这些病例说明了影像学在心脏腔室和大血管异常解剖患者中的作用，指导了导管消融的最佳导管入路。
