Introduction
Left atrial appendage (LAA) is one of the major sources of atrial arrhythmias in children1. But atrial tachycardias (AT) with an epicardial LAA origin are uncommon and usually arise from the base 2. Catheter ablation(CA) may be an important strategy for patients with atrial arrhythmias 3, especially due to the LAA firing4. Due to a large number of trabeculations and true epicardial location, endocardial CA in LAA may fail or even cause fatal tamponade2, 5. The epicardial CA may be an alternative approach 6. Because the LAA has a very thin wall and may be prone to perforation, caution should be taken when LAA ablation is performed4, even if epicardial ablation. There may be recurrence of AT, and surgical left atrial appendectomy (SAE) may be required.
We report one child with incessant AT that was found to be arising from epicardial LAA, in whom CA was successfully done through epicardial approach with subsequent surgical appendectomy without any complications. We aimed to evaluate the feasibility of epicardial ablation with subsequent SAE in children.