Three-dimensional electroanatomical mapping for atrioventricular nodal reentrant tachycardia associated with persistent left superior vena cava

BackgroundThe anatomical courses of the slow pathway and His bundle are altered in patients with atrioventricular nodal reentrant tachycardia (AVNRT) associated with persistent left superior vena cava (PLSVC). We report a case of successful catheter ablation in such a patient using an electroanatomical approach with a three-dimensional mapping system.CaseA 33-year-old woman underwent catheter ablation for AVNRT. The conventional approach for ablating the atrial end of the slow pathway was unsuccessful; therefore, a second attempt was made using a three-dimensional electroanatomical mapping system. The ablation was easily performed without damaging the His bundle because of a clear understanding of the anatomical relationships.ConclusionThe electroanatomical approach using a three-dimensional mapping system can be an alternative if conventional methods prove to be technically difficult because this new approach can provide precise spatial distribution of the pathways.