Two Cases of Paroxysmal Atrial Fibrillation in Patients Successfully Treated by Radiofrequency Catheter Ablation with Severely Compression, Lateral Displacement, and Clockwise Rotation of Their Hearts Due to Severe Pectus Excavatum

Atsushi Tanaka, Masao Takemoto, Honsa Kang, Ryota Aoki, Yoshibumi Antoku, Takahiro Mito, Satoko Kinoshita, Atsutoshi Matsuo, Satoru Hida, Teiji Okazaki, Kei-ichiro Tayama, Ken-ichi Kosuga
2018 Internal medicine (Tokyo. 1992)  
Two cases with severe pectus excavatum and symptomatic atrial fibrillation (AF) underwent radiofrequency catheter ablation (RFCA). Their chest X-ray and computed tomography (CT) findings revealed lateral displacement and clockwise rotation of their hearts, and severe right atrial and mild right ventricular compression against the sternum, but no left atrium compression against the spinal column. The procedure was therefore carefully performed under guidance with CT, intra-cardiac echography,
more » ... diac echography, atriography, and a threedimensions mapping system. Finally, the AF was successfully treated by RFCA without any complications. These findings underscore the importance of understanding cases of abnormal anatomy and carefully designing a strategy before performing any procedure.
doi:10.2169/internalmedicine.1313-18 pmid:29984756 fatcat:jcwphjwavjgxngofcoro2o53dy