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Streamlined One-stop Surgical Management for an Older Patient with Dextrocardia and Atrial Fibrillation: A Case Report

Abstract

Cui Zhenyu, Han Suxia and Xiang Yan

Dextrocardia, a rare congenital heart defect, becomes exceedingly unusual when accompanied by Atrial Fibrillation (AF). With the advancements in AF-related guidelines, anticoagulation therapy has become increasingly important. Lifelong oral anticoagulants remain imperative after successful AF ablation. Percutaneous Left Atrial Appendage Occlusion (LAAO) is an efficacious and secure strategy for averting AF-related thromboembolic incidents, thereby confirming the progressive suitability of the one-stop approach of AF ablation + LAAO. Cryoablation, favoured for its short procedural duration and enhanced tolerability, is particularly advantageous for older patients with AF, facilitating a streamlined procedure under local anaesthesia. However, the presence of abnormal anatomical structures presents challenges to this technique. This study describes a case of successful cryoablation + LAAO performed under Intracardiac Echocardiography (ICE) guidance in an elderly patient with dextrocardia and AF, providing a reference for the treatment of AF in patients with ectopic anatomy.