Transcatheter cryoablation with 3-D mapping of an atrial ectopic tachycardia in a pediatric patient with tachycardia induced heart failure

Atrial ectopic tachycardias (AET) are often resistant to medical management and can lead to a significant reduction in cardiac function. Transcatheter cryoablation, a definitive therapy, to our knowledge has yet to be described in the pediatric population. A three-year-old male presented with AET induced heart failure which persisted despite medical management. Management was complicated by worsening heart failure and propylene glycol intoxication. He underwent transcatheter cryoablation using a 3-D navigation system with an initially successful elimination of the arrhythmia. After a late recurrence (15 months) of the AET he underwent epicardial transcatheter ablation using cryotherapy with successful elimination of the arrhythmia.