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'Two-by-two' pulmonary vein isolation in the presence of a complete situs inversus and dextrocardia: use of magnetic navigation and 3D mapping with image integration.

Interventions in patients with 'abnormal' anatomy are a challenge for every invasive cardiologist. Understanding of the underlying geometry by 3D reconstruction of a pre-acquired image is facilitating the orientation of the operator. The report describes how to perform catheter ablation of atrial fibrillation in a patient with complete situs inversus using the magnetic navigation system in conjunction to electroanatomical mapping.