Multipath joint ablation strategy for focal atrial tachycardia originating from patent foramen ovale: a case report

• DOI: 10.3389/fcvm.2024.1424187
• Publication Date: 2025-01-08T06:16:52Z
• Authors: Fuqiang Liu; Yifei Li; Song Yan; Lijun Liu; Kaiyu Zhou; Yimin Hua
• Keywords: Atrial tachycardia

Focal atrial tachycardia (FAT) is predominant in the pediatric population. Recent research has identified cases of sustained FAT originating from interatrial septum (IAS); a subset presents unique challenge, with foci peri-patent foramen ovale (peri-PFO), requiring specialized management during catheter ablation. Here, we present rare case peri-PFO-associated that resulted tachycardia-related cardiomyopathy and propose comprehensive multipath joint strategy for successful treatment PFO-associated FAT. A 10-year-old boy presented refractory associated incessant tachycardia, unresponsive to metoprolol. 12-lead electrocardiogram revealed narrow QRS complex rate 157 beats per minute prolonged RP relationship. Echocardiography indicated severely reduced ejection fraction 22%. Subsequent electrophysiological study findings as anterior limbus PFO. Radiofrequency ablation was performed at earliest activation site surrounding structures, encompassing right septum, non-coronary sinus Valsalva, left atrium peri-PFO. Post-procedure, patient remained free arrhythmia showed restored normal cardiac function prescribed low-dose β-blocker 1 month. Remarkably, continued be well without need any medications subsequent 3 months. The structure PFO brought significant challenges performing beneficial managing based on its anatomical vicinity target.