Discussion
In the current case, AT originated at the apex of upper lobe on LAA. The AT could not be terminated by endocardial CA but eliminated by epicardial CA. To the best of our knowledge, this is the first report on one child illustrating an AT with an epicardial LAA origin that was successfully ablated through epicardial approach with subsequent surgical appendectomy. The termination of AT and a decrease in LAD and NT-proBNP were achieved during the 12-month follow-up. On the whole, the preliminary results were inspiring.