Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-13T00:43:40.712Z Has data issue: false hasContentIssue false
  • English
  • Français

Successful video-assisted thoracoscopic atrial appendectomy in a 4-year-old child with intractable atrial tachycardia and tachycardia-induced cardiomyopathy

Part of: Surgery

Published online by Cambridge University Press:  04 November 2019

Hye W. Kwon Open the ORCID record for Hye W. Kwon [Opens in a new window] ,
Eun J. Bae ,
Jae G. Kwak  and
Jeong W. Seo
Hye W. Kwon
Affiliation:
Department of Pediatrics, Seoul National University Hospital, Seoul, South Korea
Eun J. Bae*
Affiliation:
Department of Pediatrics, Seoul National University Hospital, Seoul, South Korea
Jae G. Kwak
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, South Korea
Jeong W. Seo
Affiliation:
Department of Pathology, Seoul National University Hospital, Seoul, South Korea
*
Author for correspondence: E. J. Bae, MD, PhD, Department of Pediatrics, Seoul National University Hospital, 101 Daehak-Ro, Jongno-gu, Seoul 03080, Korea. Tel: +82 2 2072 3097; Fax: +82 2 743 3455; E-mail: eunjbaek@snu.ac.kr
Get access Rights & Permissions [Opens in a new window]

Abstract

A 4-year-old boy presented with intractable atrial tachycardia and heart failure. Antiarrhythmic drugs, such as digoxin, beta-blockers, and amiodarone were ineffective. Although we attempted multiple radiofrequency catheter ablations, the atrial tachycardia arising from left atrial appendage frequently recurred. Finally, we decided to perform atrial appendectomy using the thoracoscopic approach. Immediately after the appendectomy, the atrial tachycardia was terminated and restored to sinus rhythm. Left ventricular ejection fraction increased from 33 to 60% within 1 week. He had no arrhythmia during the subsequent 9-month follow-up period. Minimally invasive thoracoscopic surgery can be applied even in a small child who has focal atrial tachycardia originating from an atrial appendage.

Keywords

Atrial tachycardiacardiomyopathythoracoscopic surgery
Type
Brief Report
Information
Cardiology in the Young , Volume 30 , Issue 6 , June 2020 , pp. 869 - 872
Copyright
© Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ge, H, Li, X, Liu, H, Jiang, H. Predictors of pharmacological therapy of ectopic atrial tachycardia in children. Pediatr Cardiol 2017; 38: 289–295.CrossRefGoogle ScholarPubMed
Medi, C, Kalman, JM, Haqqani, H, et al. Tachycardia-mediated cardiomyopathy secondary to focal atrial tachycardia: long-term outcome after catheter ablation. J Am Coll Cardiol 2009; 53: 1791–1797.CrossRefGoogle ScholarPubMed
Salerno, JC, Kertesz, NJ, Friedman, RA, Fenrich, AL. Clinical course of atrial ectopic tachycardia is age-dependent: results and treatment in children < 3 or > or =3 years of age. J Am Coll Cardiol 2004; 43: 438–444.CrossRefGoogle ScholarPubMed
Toyohara, K, Fukuhara, H, Yoshimoto, J, Ozaki, N, Nakamura, Y.Electrophysiologic studies and radiofrequency catheter ablation of ectopic atrial tachycardia in children. Pediatr Cardiol 2011; 32: 40–46.CrossRefGoogle ScholarPubMed
Cummings, RM, Mahle, WT, Strieper, MJ, et al. Outcomes following electroanatomic mapping and ablation for the treatment of ectopic atrial tachycardia in the pediatric population. Pediatr Cardiol 2008; 29: 393–397.CrossRefGoogle ScholarPubMed
Guo, XG, Zhang, JL, Ma, J, et al. Management of focal atrial tachycardias originating from the atrial appendage with the combination of radiofrequency catheter ablation and minimally invasive atrial appendectomy. Heart Rhythm 2014; 11: 17–25.CrossRefGoogle ScholarPubMed
Perez-Caballero-Marinez, R, Pita-Fernandez, A, Gonzalez-Lopez, M, et al. Combined ablation and exclusion of the left atrial appendage in a pediatric patient: a minimally invasive simplified approach. Ann Thorac Surg 2016; 101: 2379–2382.CrossRefGoogle Scholar
Yamada, Y, Ajiro, Y, Shoda, M, et al. Video-assisted thoracoscopy to treat atrial tachycardia arising from left atrial appendage. J Cardiovasc Electrophysiol 2006; 17: 895–898.CrossRefGoogle ScholarPubMed