ArticleJACC. Case reports2026
Left Variant Atypical Atrioventricular Nodal Reentrant Tachycardia Associated With Situs Inversus Totalis.
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
backgroundLeft variant type slow-slow atrioventricular nodal reentrant tachycardia (AVNRT) is rare, and its occurrence in patients with situs inversus totalis has not been previously reported. CASE SUMMARY: A patient with situs inversus totalis presented with recurrent supraventricular tachycardia. Electrophysiological study excluded atrioventricular reentrant tachycardia and atrial tachycardia, supporting a diagnosis of left variant slow-slow AVNRT. Catheter ablation targeting the left atrial slow pathway at the inferolateral mitral annulus was performed using cardiac computed tomography and high-density electroanatomical mapping. Tachycardia was terminated with a single radiofrequency application and was no longer inducible. DISCUSSION: Catheter ablation in patients with situs inversus is technically challenging because of mirror-image anatomy, but advanced imaging and electroanatomical mapping allow accurate localization of the arrhythmogenic substrate and safe ablation. TAKE-HOME MESSAGES: Left variant slow-slow AVNRT can occur in patients with situs inversus totalis. Advanced imaging and electroanatomical mapping facilitate safe ablation despite anatomical complexity.
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