Arrhythmias & electrophysiology
Surgical and Ablation Therapies for Atrial Appendage Tachycardia in Children
Authors' conclusion
RFCA for AT originating from the atrial appendage in children has relatively low success and high recurrence rates. Electrophysiological mapping and surgical resection is a safe and effective alternative. In particular, in cases of AT originating from the RAA and unresponsive to RFCA, the possibility of an atrial appendage aneurysm should be considered.
Study context
- Population
- Pediatric patients diagnosed with atrial tachycardia (AT) originating from the atrial appendage, identified through radiofrequency ablation (RFCA) diagnostics, January 2010 to February 2022
- Participants
- 70 pediatric patients
- Exposure
- RFCA vs atrial appendage resection
- RFCAn = 70
- Atrial appendage resectionn = 32
- Outcome
- Tachycardia cardiomyopathy
Main finding
As reported in the abstract
Tachycardia cardiomyopathy developed
44.3%
31 of 70 patients
Observational data: associations, not effects.
Further findings
- Immediate success of RFCA
- 72.9% · 51 of 70 of 70
- Recurrence after RFCA
- 25.5% · 13 of 51 patients of 70
- Recurrence after RFCA: of the 51 with immediate success
Atrial appendage resection
- Patients who underwent atrial appendage resection because of unsuccessful ablation or recurrence
- Thirty-two (45.7%)
- Right atrial appendage (RAA) resections
- 20
- Left atrial appendage resections
- 12
Sinus rhythm after resection
- Sinus rhythm achieved in all patients without recurrence following resection
RAA aneurysms
- Of the 20 RAA resections
- 45.0% (9 of 20 patients)
- Of RAA (AT originating from the RAA)
- 22.5% (9 of 40)
- Of RFCA failures in AT originating from the RAA
- 57.1% (8 of 14)
Baseline characteristics
- Mean age
- 6.94 ± 3.46 years
- Mean weight
- 26.69 ± 13.59 kg
Original publication
Surgical and Ablation Therapies for Atrial Appendage Tachycardia in Children. JACC Clin Electrophysiol. Published 8 January 2025. doi:10.
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