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.