Successful ablation of atrioventricular node reentry tachycardia in a patient with crisscross heart and situs inversus levocardia.
Crisscross heart is a complex congenital anomaly that is rarely seen in the absence of important associated structural defects. We describe a 41-year-old woman with recurrent dizziness and tachycardia but no previous cardiovascular symptoms. Narrow-QRS tachycardia was detected, and magnetic resonance imaging showed situs inversus levocardia with a circulatory pattern typical of crisscross heart. Electrophysiologic study revealed atypical atrioventricular (AV) node reentry tachycardia of the "fast-slow" type. Despite the unusual anatomy, we successfully modified the AV node physiology by ablating the "slow AV node inputs" with the guidance of a multielectrode basket catheter in the anatomic right atrium.
Alberto Lopez
J
J
Departments of Adult Cardiology and Electrophysiology Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, TX, USA. jalopez@bcm.tmc.edu
Angelini
Paolo
P
Lufschanowski
Roberto
R
D000015:Abnormalities, Multiple / Q000601:surgery*; D000328:Adult; D017115:Catheter Ablation; D003420:Crisscross Heart / Q000453:epidemiology*; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007979:Levocardia / Q000453:epidemiology*; D018810:Magnetic Resonance Angiography; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000453:epidemiology* / Q000601:surgery*