Transjugular approach: A different access in left atrium for isolation of pulmonary vein. Case report

A 48 years old man presented with a 4 years history of paroximal atrial fibrillation insensitive to antiarrhytmic drugs. During right heart catheterizatin for electrophysiologic study, was discloved an accidental findings of azygos continuation. An aoesophageal sound was positioned to see inter atrial septum. A 7 french Mullins type transeptal sheath was introduced via jugular, into the right atrium. After transeptal catheterization, sistematic anticoagulation was acieved with intravenous heparin. Four mm irrigated tip was introduced into left atrium. A 3D shell representing the left atrium was constructed and circular lesion around the left and the right sides of pulmonary veins was created.