A case report of cryoballoon-based pulmonary vein isolation in a patient with situs inversus abdominalis and levocardia.

The main challenges include the achievement of transseptal access and manipulation of the cryoballoon to achieve a patent seal of the pulmonary veins. cbPVI eliminates the need for constant re-positioning of the ablation catheter and might facilitate the creation of durable lesions under such difficult anatomical conditions.