Left atrial appendectomy after failed catheter ablation of a focal atrial tachycardia originating in the left atrial appendage.
This report describes a case of left atrial appendectomy after a failed endocardial catheter ablation of a continuous drug-refractory left atrial appendage (LAA) tachycardia in a 9-year-old boy. Electrophysiologic study showed atrial tachycardia (AT) originating in the LAA. Numerous radiofrequency applications with an irrigated-tip catheter were ineffective. During surgery, direct pressure on the apex of the LAA by forceps immediately terminated the AT and restored sinus rhythm. After a left atrial appendectomy, the patient remained free of any arrhythmias during a follow-up period of 18 months.
Pokushalov
Evgeny
E
State Research Institute of Circulation Pathology, Rechkunovskaya 15, Novosibirsk 55, Russia 630055. E.Pokushalov@gmail.com
Romanov
Alexandr
A
Artyomenko
Sergey
S
Arhipov
Alex
A
Karaskov
Alexandr
A
D020517:Atrial Appendage / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D017115:Catheter Ablation; D002648:Child; D004452:Echocardiography; D004562:Electrocardiography; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012086:Reoperation; D013612:Tachycardia, Ectopic Atrial / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D017211:Treatment Failure