Successful left lateral AP ablation with transseptal puncture in a patient with situs inversus totalis and dextrocardia

Wolff-Parkinson-White syndrome, characterised by accessory pathways, is rarely seen with dextrocardia. We present a case of situs inversus-dextrocardia with Wolff-Parkinson-White syndrome successfully treated via catheter ablation using 3D mapping (EnSite Precision®). Adjustments included reversed electrocardiogram (ECG) electrode placement, EnSite patch positioning, and fluoroscopic views. Coronary sinus access required counterclockwise manoeuvers. Mapping identified a left-sided accessory pathway, necessitating transseptal puncture with mirror-image adjustments. Ablation at the optimal site resulted in success. This case highlights the feasibility of catheter ablation in dextrocardia with tailored procedural modifications.