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Case Reports in Pediatrics
Volume 2013 (2013), Article ID 203241, 4 pages
http://dx.doi.org/10.1155/2013/203241
Case Report

Radiofrequency Ablation of a Left Atrial Appendage Tachycardia on ECMO Support

1Department of Internal Medicine, Spectrum Health Medical Group, 100 Michigan ST NE, MC 127, Grand Rapids, MI 49503, USA
2College of Human Medicine, Michigan State University, Grand Rapids, MI 49503, USA
3Frederik Meijer Heart & Vascular Institute, Spectrum Health, Grand Rapids, MI 49503, USA
4Department of Pediatrics, University of Michigan School of Medicine, Ann Arbor, MI 48109-5718, USA

Received 15 September 2013; Accepted 22 October 2013

Academic Editors: J. Hruda and W. B. Moskowitz

Copyright © 2013 Mohsin Khan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Extracorporeal membrane oxygenation (ECMO) has been utilized in the pediatric population for cardiogenic shock secondary to medically intractable arrhythmias. There is limited experience with cardiac radiofrequency ablation (RFA) on these patients while on ECMO. A 7-year-old girl presented with a tachycardia-mediated cardiomyopathy secondary to a left atrial appendage tachycardia. She suffered a cardiac arrest due to pulseless electrical activity and was placed on ECMO. Due to elevated left atrial pressures and the refractoriness of her arrhythmia to cardioversion and antiarrhythmic therapy, while on ECMO, blade atrial septostomy and radiofrequency ablation were performed. The patient tolerated the procedure well and was successfully decannulated. Her cardiac function normalized within four weeks of the ablation procedure. Twelve months after the procedure, she remains completely well, with no symptoms or tachycardia.