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Updated: May 12, 2026

Thermal Ablation for the Treatment of Abdominal Tumors
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Thermal Ablation for the Treatment of Abdominal Tumors

Published on: March 7, 2011

Anatomic twist to a straightforward ablation.

Mandeep Singh Randhawa1, Harris C Taylor, Robert D Mosteller

  • 1Clinical Associate, Department of Hospital Medicine, Cleveland Clinic Foundation, Cleveland, Ohio.

Indian Pacing and Electrophysiology Journal
|April 11, 2013
PubMed
Summary

This study details a successful radiofrequency ablation of the atrioventricular (AV) junction in a patient with refractory atrial fibrillation and an unusual inferior vena cava anomaly. The inferior approach enabled catheter stability for complete AV block induction.

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Area of Science:

  • Cardiac Electrophysiology
  • Interventional Cardiology
  • Congenital Cardiovascular Anomalies

Background:

  • Atrioventricular (AV) junction ablation is a standard procedure for refractory atrial fibrillation.
  • Inferior vena cava (IVC) interruption is a rare congenital anomaly.
  • Anatomical variations can pose challenges during cardiac electrophysiology procedures.

Purpose of the Study:

  • To report a successful AV junction ablation in a patient with IVC interruption and heterotaxy syndrome.
  • To demonstrate the feasibility of an inferior approach for AV junction ablation in complex venous anatomy.
  • To highlight the diagnostic and therapeutic implications of identifying congenital anomalies during electrophysiology procedures.

Main Methods:

  • Radiofrequency ablation targeting the AV junction.
Keywords:
AV junction ablationAzygos vein continuationHeterotaxy syndromeIVC interruptionInferior approachSRO sheathSuperior vena cava

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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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  • Utilized an inferior approach with a Schwartz right 0 (SRO) sheath.
  • Diagnostic cardiac catheterization to identify venous anomaly.

    • Main Results:

    • Successful complete AV block was achieved using radiofrequency energy.
    • The inferior approach and specialized sheath facilitated catheter stability.
    • A heterotaxy syndrome with IVC interruption and azygos continuation was identified.

    Conclusions:

    • AV junction ablation is feasible even with complex congenital venous anomalies like IVC interruption.
    • An adapted inferior approach can overcome anatomical challenges in cardiac electrophysiology.
    • Careful assessment and adaptation are crucial for successful ablation in patients with rare anatomical variations.