Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 16, 2022; 10(20): 7006-7012
Published online Jul 16, 2022. doi: 10.12998/wjcc.v10.i20.7006
Percutaneous transhepatic access for catheter ablation of a patient with heterotaxy syndrome complicated with atrial fibrillation: A case report
Hai-Xiong Wang, Na Li, Jian An, Xue-Bin Han
Hai-Xiong Wang, Na Li, Jian An, Xue-Bin Han, Department of Cardiology, Shanxi Cardiovascular Hospital, Taiyuan 030000, Shanxi Province, China
Author contributions: Wang HX, Han XB, and An J contributed equally to this work, and designed the research study; Li N analyzed the data and wrote the manuscript; All authors have read and approved the final manuscript.
Supported by Shanxi Provincial Health Commission “Four batch” Science and Technology Innovation Project of Medical Development, No. 2021XM45 (to Dr. Wang HX); Academic promotion plan of Shanxi Cardiovascular Hospital, No. XYS20180102 (to Dr. Wang HX); Natural Science Foundation of Shanxi Province, No. 20210302123346 (to Dr. Wang HX); and Scientific Research Incentive Fund of Shanxi Cardiovascular Hospital, No. XYS20190206 (to Dr. Li N).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xue-Bin Han, Doctor, MD, Chief Doctor, Department of Cardiology, Shanxi Cardiovascular Hospital, No. 18 Yifen Street 18, Wan Bailin District, Taiyuan 030000, Shanxi Province, China. ty2021hxb@126.com
Received: November 18, 2021
Peer-review started: November 18, 2021
First decision: April 7, 2022
Revised: April 14, 2022
Accepted: May 22, 2022
Article in press: May 22, 2022
Published online: July 16, 2022
Processing time: 228 Days and 10.8 Hours
Abstract
BACKGROUND

Atrial fibrillation (AF) is one of the most common arrhythmias, and radiofrequency catheter ablation is the most effective treatment strategy. The inferior vena cava (IVC) is a common approach for radiofrequency ablation of AF. However, this approach may not be applied to some cases such as chronic venous occlusions, surgical ligation of the IVC, and heterotaxy syndrome (HS).

CASE SUMMARY

A 68-year-old man with HS suffered from severely symptomatic persistent AF for 9 years, and we successfully ablated by percutaneous transhepatic access.

CONCLUSION

In patients without femoral vein access, the use of the hepatic vein for pulmonary vein isolation is a viable alternative for invasive electrophysiology procedures.

Keywords: Transhepatic access; Catheter ablation; Atrial fibrillation; Case report

Core Tip: The inferior vena cava (IVC) is a commonly used method for radiofrequency ablation of atrial fibrillation. In some situations, this method cannot be used such as chronic venous occlusions, surgical ligation of the IVC, and heterotaxy syndrome. In patients without femoral vein access, hepatic vein approach for pulmonary vein isolation is a viable option for invasive electrophysiology procedures.