Key result
Radiofrequency ablation successfully terminates refractory pediatric left atrial tachycardia, enabling complete ECMO recovery.
Case Report (n=1)
Radiofrequency ablation can be safely and effectively performed in pediatric patients on ECMO for medically intractable tachycardia-mediated cardiomyopathy.
May support ablation on ECMO in refractory pediatric tachycardia-mediated cardiomyopathy; hypothesis-generating and should not yet change practice.
Extracorporeal membrane oxygenation (ECMO) has been utilized in the pediatric population for cardiogenic shock secondary to medically intractable arrhythmias. There is limited experience with cardiac radiofrequency ablation (RFA) on these patients while on ECMO. A 7-year-old girl presented with a tachycardia-mediated cardiomyopathy secondary to a left atrial appendage tachycardia. She suffered a cardiac arrest due to pulseless electrical activity and was placed on ECMO. Due to elevated left atrial pressures and the refractoriness of her arrhythmia to cardioversion and antiarrhythmic therapy, while on ECMO, blade atrial septostomy and radiofrequency ablation were performed. The patient tolerated the procedure well and was successfully decannulated. Her cardiac function normalized within four weeks of the ablation procedure. Twelve months after the procedure, she remains completely well, with no symptoms or tachycardia.
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Khan et al. (2013) conducted a case report in Left atrial appendage tachycardia with tachycardia-mediated cardiomyopathy (n=1). Radiofrequency ablation on ECMO support was evaluated on Termination of tachycardia and recovery of cardiac function. Radiofrequency ablation of a left atrial appendage tachycardia was successfully performed on a 7-year-old girl on ECMO support, resulting in complete recovery of cardiac function.
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