Atrioventricular reentrant tachycardia in a child with tricuspid atresia: A case report of catheter ablation

Rationale: Atrioventricular reentrant tachycardia (AVRT) is the most common supraventricular tachycardia occurring in children. However, in complex congenital heart disease patients with a different heart anatomy and conduction system morphology, accessory pathway modification may be particularly challenging because of distortion of typical anatomic landmarks. Patient concerns: A 10-year-old boy with tricuspid atresia and history of bidirectional Glenn operation had recurrent chest distress and palpitation for 3 months. He had multiple hospitalizations for narrow-QRS tachycardia with poor hemodynamic tolerance, despite the use of adenosine and amiodarone. Diagnoses: AVRT. Tricuspid atresia with secundum atrial septal defect, large ventricular septal defect, and right ventricular outflow tract stenosis. Interventions: Cardiac catheterization, electrophysiological examination, and ablation. Outcomes: The child has not had a recurrent AVRT during 6 months of follow-up and is waiting for Fontan operation. Lessons: Since there is an increased risk of accessory pathways in patients with tricuspid atresia, all these patients should be checked before the Fontan operation to exclude congenital accessory pathways.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research