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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
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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

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