Successful cryoablation for typical atrial flutter in a toddler with sinus node dysfunction: the youngest case report
Mohammad A Ebrahim, Hasan Majid, Mohamed A Abdelnaby, J Philip Saul
TL;DR
A toddler with heart rhythm issues successfully underwent a less invasive procedure to treat atrial flutter, avoiding the need for a pacemaker.
Contribution
This is the youngest reported case of successful cryoablation for typical atrial flutter in a child with sinus node dysfunction.
Findings
Cryoablation successfully terminated atrial flutter in a 2.8-year-old with sinus node dysfunction.
No recurrence was observed after more than 1.5 years of follow-up.
The procedure avoided pacemaker implantation and offered a less invasive alternative.
Abstract
We describe the youngest (2.8 years, 9 kg) successful cavotricuspid isthmus (CTI) cryoablation whose medical management was complicated with severe sinus node dysfunction and recurrent atrial flutter despite medical therapy (sotalol). Two-catheter, zero fluoroscopy electrophysiology study was performed using EnSite PrecisionTM mapping system. Cavotricuspid isthmus proved to be ‘in’ circuit with entrainment. Point-by-point 2 min cryolesions resulted in termination of atrial flutter, and later bidirectional block (>120 ms) was confirmed. There was no recurrence post-ablation (>1.5-year follow-up). Ablation offers a less invasive approach (vs. pacemaker implantation) to toddlers with tachyarrhythmia and coexisting conduction disease, limiting medical management option.
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Taxonomy
TopicsCardiac Arrhythmias and Treatments · Atrial Fibrillation Management and Outcomes · Cardiac electrophysiology and arrhythmias