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Updated: May 31, 2026

Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
Published on: February 11, 2022
Left Variant Atypical Atrioventricular Nodal Reentrant Tachycardia Associated With Situs Inversus Totalis
Yuki Tanaka1, Itsuro Morishima1, Yasunori Kanzaki1
1Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan.
Background:
Left 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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