ArticleJACC. Case reports2026
Radiofrequency Ablation for Typical Atrial Flutter in Dextroversion With PLSVC and IVC Interruption.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCongenital interruptions of the inferior vena cava (IVC) and persistent left superior vena cava (PLSVC) are rare. When combined with dextroversion, they pose significant challenges for catheter ablation. CASE SUMMARY: A 65-year-old man with 2-year palpitations (worsened for half a month) had typical atrial flutter and dextroversion on ECG. Echocardiography showed PLSVC; computed tomography angiography confirmed IVC interruption. Ablation was successfully performed via a left superior venous approach with 3D mapping, targeting the cavotricuspid isthmus between the tricuspid annulus and hepatic vein. DISCUSSION: This is the first reported case of atrial flutter ablation in a patient with coexisting dextroversion, PLSVC, and IVC interruption. It highlights the importance of anatomical recognition and adaptive strategies. TAKE-HOME MESSAGES: Preprocedural imaging is crucial in cardiac malformation. Alternative access routes and 3D mapping are key to successful ablation in complex anatomy.
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