Pace-mapping guided approach on 3-dimensional imaging predicted the origin of ventricular tachycardia in a non-mirrored dextrocardia patient with counter-clockwise rotation of the cardiac apex: Usefulness of aVR lead for estimation

Catheter ablation for premature ventricular contraction (PVC)/ventricular tachycardia (VT) is challenging in patients with dextrocardia because of morphological changes and abnormal cardiac rotation. Successful ablation of PVCs/VTs originating from the right ventricular outflow tract (RVOT) has been reported in patients with dextrocardia.1,2 Nevertheless, abnormalities of dextrocardia involve several variations and other congenital heart diseases, and PVC/VT ablation in atypical dextrocardia with the apex rotated counterclockwise has not previously been reported.