Focal atrial tachycardia with frequencies up to 200/min in an 11-year-old girl had
been resistant to drugs over a period of 5 years. An electrophysiological study demonstrated
a left atrial ectopic tachycardia. Intraoperative epicardial mapping localized the
automatic focus at the base of the left atrial appendage. Excision of the appendage
and cryoablation of the adjacent area were performed using cardiopulmonary bypass.
Histologic examination of the excised tissue showed no specific alterations aside
from islets of fatty tissue. The girl has been in sinus rhythm and has shown no tachycardias
during the 6 months following the operation. A review of the literature, covering
17 cases of right and 12 cases of left atrial foca! tachycardia, indicates excision
of the atrial tissue in combination with cryoablation to be the treatment of choice
to ensure success.
Ectopic atrial tachycardia - Electrophysiologic study - Antiarrhythmic surgery
