Abstract
Background
There are few literature reports of atrial tachycardia-induced cardiomyopathy in children, and fewer cases have been effectively treated by radiofrequency catheter ablation. Therefore, we conducted a clinical summary of 6 cases of atrial tachycardia-induced cardiomyopathy in children in Wuhan Children's Hospital. To investigate the effectiveness and safety of radiofrequency ablation for atrial tachycardia cardiomyopathy.
Methods
A total of 6 children (4 girls and 2 boys) diagnosed with atrial tachycardia-induced cardiomyopathy and admitted to Wuhan Children's Hospital from January 2017 to April 2024 were selected. An intracardiac electrophysiological study was performed in all 6 children to confirm the origin of the atrial tachycardia and the presence of decreased cardiac function. All children were followed up 2 to 12 months after RFCA or in combination with atrial appendectomy, and left ventricular end-diastolic diameter and left ventricular ejection fraction were observed.
Results
The age range was 3.6 to 12.5 years and the median age was 10 years. The results of the intracardiac electrophysiological examination of the 6 cases showed that the origin came from the right pulmonary vein in 2 cases, from the left pulmonary vein in 2 cases, from the left atrial appendage in one case, and from the right atrial appendage in one case. Four cases of tachycardia-induced cardiomyopathy originating in the left and right pulmonary veins were successfully eliminated by radiofrequency catheter ablation (RFCA). In two children with tachycardia-induced cardiomyopathy in the atrial appendage, atrial appendectomy was performed with parental consent after precise localization of the RFCA. After RFCA or in combination with atrial appendectomy, 5 children were followed for more than 1 year and 1 child for 2 months. All children had sinus rhythm. At the same time, the left ventricular ejection fraction after RFCA or combined atrial appendectomy was significantly increased in 6 cases, indicating statistical significance (P < 0.01), but the left ventricular end-diastolic diameter was not statistically significant in the treatment (P > 0.05).
Conclusions
Sustained atrial tachycardia can lead to the occurrence of cardiomyopathy such as cardiac enlargement and heart failure. RFCA and combined atrial appendectomy can effectively stop tachycardia, eliminate the mechanism of tachycardia, and allow complete recovery of cardiac function.