Published online Jul 16, 2022. doi: 10.12998/wjcc.v10.i20.7006
Peer-review started: November 18, 2021
First decision: April 7, 2022
Revised: April 14, 2022
Accepted: May 22, 2022
Article in press: May 22, 2022
Published online: July 16, 2022
Atrial fibrillation (AF) is one of the most common arrhythmias, and radiofrequency catheter ablation is the most effective treatment strategy. The inferior vena cava (IVC) is a common approach for radiofrequency ablation of AF. However, this approach may not be applied to some cases such as chronic venous occlusions, surgical ligation of the IVC, and heterotaxy syndrome (HS).
A 68-year-old man with HS suffered from severely symptomatic persistent AF for 9 years, and we successfully ablated by percutaneous transhepatic access.
In patients without femoral vein access, the use of the hepatic vein for pulmonary vein isolation is a viable alternative for invasive electrophysiology procedures.
Core Tip: The inferior vena cava (IVC) is a commonly used method for radiofrequency ablation of atrial fibrillation. In some situations, this method cannot be used such as chronic venous occlusions, surgical ligation of the IVC, and heterotaxy syndrome. In patients without femoral vein access, hepatic vein approach for pulmonary vein isolation is a viable option for invasive electrophysiology procedures.