Multipath joint ablation strategy for focal atrial tachycardia originating from patent foramen ovale: a case report
IntroductionFocal atrial tachycardia (FAT) is predominant in the pediatric population. Recent research has identified cases of sustained FAT originating from the interatrial septum (IAS); a subset of cases presents a unique challenge, with foci originating from the peri-patent foramen ovale (peri-PF...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1424187/full |
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| author | Fuqiang Liu Yifei Li Song Yan Lijun Liu Kaiyu Zhou Yimin Hua |
| author_facet | Fuqiang Liu Yifei Li Song Yan Lijun Liu Kaiyu Zhou Yimin Hua |
| author_sort | Fuqiang Liu |
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| description | IntroductionFocal atrial tachycardia (FAT) is predominant in the pediatric population. Recent research has identified cases of sustained FAT originating from the interatrial septum (IAS); a subset of cases presents a unique challenge, with foci originating from the peri-patent foramen ovale (peri-PFO), requiring specialized management during catheter ablation. Here, we present a rare case of peri-PFO-associated FAT that resulted in tachycardia-related cardiomyopathy and propose a comprehensive multipath joint strategy for the successful treatment of PFO-associated FAT.Case presentationA 10-year-old boy presented with refractory cardiomyopathy associated with incessant atrial tachycardia, unresponsive to metoprolol. A 12-lead electrocardiogram revealed a narrow QRS complex tachycardia with a rate of 157 beats per minute and a prolonged RP relationship. Echocardiography indicated a severely reduced ejection fraction of 22%. Subsequent electrophysiological study findings identified the tachycardia as originating from the anterior limbus of the PFO. Radiofrequency ablation was performed at the earliest activation site and surrounding structures, encompassing the right atrial septum, non-coronary sinus of Valsalva, and the left atrium peri-PFO. Post-procedure, the patient remained free from arrhythmia and showed restored normal cardiac function and was prescribed a low-dose β-blocker for 1 month. Remarkably, the patient continued to be well without the need for any medications for the subsequent 3 months.ConclusionThe structure of the PFO brought significant challenges in performing successful ablation. The multipath strategy was beneficial in managing peri-PFO-associated FAT based on its anatomical vicinity of the target. |
| format | Article |
| id | doaj-art-2de3a2522d114fce9ec3eed653caf4fb |
| institution | Kabale University |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-01-01 |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-2de3a2522d114fce9ec3eed653caf4fb2025-01-08T06:11:46ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-01-011110.3389/fcvm.2024.14241871424187Multipath joint ablation strategy for focal atrial tachycardia originating from patent foramen ovale: a case reportFuqiang Liu0Yifei Li1Song Yan2Lijun Liu3Kaiyu Zhou4Yimin Hua5Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children of MOE, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children of MOE, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Nursing, West China Second University Hospital, Sichuan University, Chengdu, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children of MOE, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children of MOE, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, ChinaIntroductionFocal atrial tachycardia (FAT) is predominant in the pediatric population. Recent research has identified cases of sustained FAT originating from the interatrial septum (IAS); a subset of cases presents a unique challenge, with foci originating from the peri-patent foramen ovale (peri-PFO), requiring specialized management during catheter ablation. Here, we present a rare case of peri-PFO-associated FAT that resulted in tachycardia-related cardiomyopathy and propose a comprehensive multipath joint strategy for the successful treatment of PFO-associated FAT.Case presentationA 10-year-old boy presented with refractory cardiomyopathy associated with incessant atrial tachycardia, unresponsive to metoprolol. A 12-lead electrocardiogram revealed a narrow QRS complex tachycardia with a rate of 157 beats per minute and a prolonged RP relationship. Echocardiography indicated a severely reduced ejection fraction of 22%. Subsequent electrophysiological study findings identified the tachycardia as originating from the anterior limbus of the PFO. Radiofrequency ablation was performed at the earliest activation site and surrounding structures, encompassing the right atrial septum, non-coronary sinus of Valsalva, and the left atrium peri-PFO. Post-procedure, the patient remained free from arrhythmia and showed restored normal cardiac function and was prescribed a low-dose β-blocker for 1 month. Remarkably, the patient continued to be well without the need for any medications for the subsequent 3 months.ConclusionThe structure of the PFO brought significant challenges in performing successful ablation. The multipath strategy was beneficial in managing peri-PFO-associated FAT based on its anatomical vicinity of the target.https://www.frontiersin.org/articles/10.3389/fcvm.2024.1424187/fullatrial tachycardiacatheter ablationtachycardia associated cardiomyopathypatent foramen ovalemanaging strategycase report |
| spellingShingle | Fuqiang Liu Yifei Li Song Yan Lijun Liu Kaiyu Zhou Yimin Hua Multipath joint ablation strategy for focal atrial tachycardia originating from patent foramen ovale: a case report Frontiers in Cardiovascular Medicine atrial tachycardia catheter ablation tachycardia associated cardiomyopathy patent foramen ovale managing strategy case report |
| title | Multipath joint ablation strategy for focal atrial tachycardia originating from patent foramen ovale: a case report |
| title_full | Multipath joint ablation strategy for focal atrial tachycardia originating from patent foramen ovale: a case report |
| title_fullStr | Multipath joint ablation strategy for focal atrial tachycardia originating from patent foramen ovale: a case report |
| title_full_unstemmed | Multipath joint ablation strategy for focal atrial tachycardia originating from patent foramen ovale: a case report |
| title_short | Multipath joint ablation strategy for focal atrial tachycardia originating from patent foramen ovale: a case report |
| title_sort | multipath joint ablation strategy for focal atrial tachycardia originating from patent foramen ovale a case report |
| topic | atrial tachycardia catheter ablation tachycardia associated cardiomyopathy patent foramen ovale managing strategy case report |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1424187/full |
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