Hedayati Godarzi Mohammad Taghi, Abrotan Saeed, Younesi Fatemeh, Rashid Mohamad, Bijani Ali
Department of Cardiology, Babol University of Medical Sciences, Babol, Iran.
Department of Cardiology, Zanjan University of Medical Science, Zanjan, Iran.
Caspian J Intern Med. 2025 Mar 17;16(2):375-380. doi: 10.22088/cjim.16.2.375. eCollection 2025 Spring.
Congenital anomalies can pose challenges during electrophysiology (EP) procedures in patients with tachyarrhythmias, making diagnosis and management of these cases quite difficult. An interrupted inferior vena cava, an uncommon congenital defect, is especially rare without associated congenital heart disease. In this setting, catheter ablation from femoral vein access becomes more challenging.
A 23-year-old male with no cardiovascular risk factors or prior cardiovascular disease presented with atrioventricular reentrant tachycardia that converted to sinus rhythm after adenosine administration. The patient was scheduled for an electrophysiology study with catheter ablation if indicated. During the procedure, catheter advancement into the right atrium was unsuccessful, raising suspicion of an interrupted inferior vena cava (IVC). Radiofrequency ablation was subsequently performed successfully via the subclavian vein approach. Post-procedural computed tomography (CT) imaging confirmed interruption of the IVC.
Accessing via the subclavian vein can facilitate catheter ablation when an interrupted inferior vena cava is present.
先天性异常在快速心律失常患者的电生理（EP）手术过程中可能带来挑战，使得这些病例的诊断和管理相当困难。下腔静脉中断是一种罕见的先天性缺陷，在无相关先天性心脏病的情况下尤为罕见。在这种情况下，经股静脉途径进行导管消融变得更具挑战性。
一名23岁男性，无心血管危险因素或既往心血管疾病史，因房室折返性心动过速就诊，静脉注射腺苷后转为窦性心律。如果有指征，该患者计划进行电生理检查及导管消融。在手术过程中，导管进入右心房未成功，怀疑存在下腔静脉中断（IVC）。随后通过锁骨下静脉途径成功进行了射频消融。术后计算机断层扫描（CT）成像证实了下腔静脉中断。
当下腔静脉中断时，经锁骨下静脉途径有助于导管消融。
