Cryoballoon Left Atrial Posterior Wall Isolation Using the Cross-over Technique in Situs Inversus with Dextrocardia: A Case Report

Clicks: 16
ID: 327895
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Steady

Ranked #238 of 408 articles by views in European Heart Journal - Case Reports

Most read Least read

Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 408 in total.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
Abstract Background Situs inversus with dextrocardia (SID) is a rare congenital condition with fully mirrored cardiac anatomy, posing unique technical challenges for catheter ablation of atrial fibrillation (AF). Although cryoballoon (CB)-based left atrial posterior wall isolation (LAPWI) has recently been reported in a patient with SID, adjunctive radiofrequency catheter ablation was required to complete posterior wall isolation. We present a case in which complete LAPWI was achieved exclusively using CB applications with the previously described cross-over technique. Case summary A 69-year-old woman with SID and drug-refractory persistent AF underwent catheter ablation using a fourth-generation CB system. To accommodate mirrored anatomy, the procedure was performed using mirror-image fluoroscopy and intentionally reversed catheter manipulation to restore conventional spatial orientation. Pulmonary vein isolation was achieved, followed by LAPWI using the cross-over technique, in which overlapping CB applications were delivered from both left- and right-sided pulmonary vein anchor positions to improve lesion continuity across the left atrial posterior wall. Complete LAPWI was confirmed by voltage mapping and pacing maneuvers demonstrating both entrance and exit block. No periprocedural complications occurred. The patient remained free from AF recurrence for 48 months without antiarrhythmic therapy. Discussion This case demonstrates that complete CB-based LAPWI using the cross-over technique is feasible even in anatomically mirrored hearts. The successful use of mirror-image fluoroscopy and intentionally reversed catheter manipulation provides practical technical insights and highlights the importance of deliberate spatial adaptation when performing complex left atrial ablation in patients with SID.
Reference Key
openalex_W7211909019 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Fuminori Odagiri, Takashi Tokano, Tetsuro Miyazaki, Kai Ishii, Tohru Minamino
Are you one of these authors? Claim your profile
Journal European Heart Journal - Case Reports
Year 2026
DOI
10.1093/ehjcr/ytag674
URL
https://doi.org/10.1093/ehjcr/ytag674
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.