Transhepatic radiofrequency ablation of a cavotricuspid isthmus–dependent atrial flutter Zahra Jehan Iqbal, MD, Long Cao, MD, Karl Chiang, MD, Sundeep.

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Presentation transcript:

Transhepatic radiofrequency ablation of a cavotricuspid isthmus–dependent atrial flutter Zahra Jehan Iqbal, MD, Long Cao, MD, Karl Chiang, MD, Sundeep Adusumalli, MD, Farah Khalid, BA, Rajasekhar Nekkanti, MD HeartRhythm Case Reports Volume 2, Issue 3, Pages 241-243 (May 2016) DOI: 10.1016/j.hrcr.2016.01.010 Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 1 A: Negative deflections in II, III, and aVF (inferior leads) and positive deflections in V1 (criteria for flutter) suggesting cavotricuspid isthmus–dependent atrial flutter. B: Left internal jugular and left subclavian veins were the final access points still available, and losing this access was undesirable. C: Postprocedure electrocardiogram, which illustrates the termination of atrial flutter. HeartRhythm Case Reports 2016 2, 241-243DOI: (10.1016/j.hrcr.2016.01.010) Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 2 A: Placement of a second sheath with a 0.018 wire through a 22-gauge Chiba needle placed into a superficial hepatic vein via Doppler ultrasound and guided into the IVC. B: Coils being placed to prevent bleeding complications. C: 9F and 7F sheaths were placed into the right hepatic vein and middle hepatic vein, respectively, and advanced, as seen, with contrast to the right atrial junction. D: Two coils were placed to prevent peritoneal bleeding. IVC = inferior vena cava. HeartRhythm Case Reports 2016 2, 241-243DOI: (10.1016/j.hrcr.2016.01.010) Copyright © 2016 Heart Rhythm Society Terms and Conditions