Unusual cause of myocardial ischemia in an infant.

Abnormal coronary artery anatomy should be ruled out in any patient with myocardial dysfunction and an abnormal electrocardiogram. The reported etiologies of infantile myocardial ischemia are abnormalities of coronary arteries, perinatal asphyxia, umbilical catheterization, and myocarditis. Generalized arterial calcification of infancy, although rare, should be considered in the differential diagnosis of infantile myocardial ischemia if coronary artery origin is found to be normal on echocardiography.

Initial experience with novel mobile cardiac outpatient telemetry for children and adolescents with suspected arrhythmia.

Objectives: To report use of a novel mobile cardiac outpatient telemetry (MCOT) system for evaluation of children and adolescents with suspected cardiac arrhythmia.

Design: Prospective data collection and retrospective analysis.

Setting: All patients who received MCOT from The Children's Hospital at the Cleveland Clinic between 1/14/04 and 2/12/05 were screened.

Percutaneous pericardial instrumentation for catheter ablation of focal atrial tachycardias arising from the left atrial appendage.

Focal atrial tachycardias originating from the left atrial appendage present unique anatomic challenges for successful ablation. We describe the role of minimally invasive percutaneous epicardial mapping and ablation in the management of two patients with ectopic atrial tachycardias arising from the left atrial appendage following failure of a conventional endocardial approach to achieve cure.