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.