Broad and narrow complex tachycardia resulting in cardiorespiratory arrest in a child: what is the optimal treatment strategy?

Background: We describe a child with a broad and narrow complex tachycardia causing haemodynamic collapse.

Case Summary: A 9-year-old girl (weight 26 kg, height 114 cm) with a 5-year history of refractory 'epilepsy' presented with cardiorespiratory arrest and tonic-clonic seizure, witnessed by her mother. Electrocardiogram documented recurrent episodes of simultaneous broad and narrow tachycardias associated with haemodynamic compromise.

High-density electroanatomic activation mapping to guide slow pathway modification in patients with persistent left superior vena cava.

Background: Slow pathway (SP) mapping and modification can be challenging in patients with persistent left superior vena cava (PLSVC) due to anatomic variance of the Koch triangle (KT) and coronary sinus (CS) dilation. Studies using detailed 3-dimensional (3D) electroanatomic mapping (EAM) to investigate conduction characteristics and guide ablation targets in this condition are lacking.

Objectives: The purpose of this study was to describe a novel technique of SP mapping and ablation in sinus rhythm using 3D EAM in patients with PLSVC after validation in a cohort with normal CS anatomy.

Targeted cluster ablation of non-CTI-dependent atrial arrhythmias in congenital heart disease using ultrahigh-definition mapping.

Background: Ablation of atrial arrhythmias in patients with congenital heart disease (CHD) has markedly improved with advanced mapping systems. However, recurrence rates remain high. The linear ablation strategy is not uncommonly practiced necessitating prolonged ablation times.

Outcomes From Pediatric Ablation: A Review of 20 Years of National Data.

Objectives: This study set out to examine outcomes from pediatric supraventricular tachycardia ablations over a 20-year period. This study sought to examine success rates and repeat ablations over time and to evaluate whether modalities such as 3-dimensional (3D) mapping, contact force, and cryotherapy have improved outcomes.

Background: Ablation of supraventricular tachycardia in pediatric patients is commonly performed in most congenital heart centers with excellent long-term results.

Clinical outcomes and programming strategies of implantable cardioverter-defibrillator devices in paediatric hypertrophic cardiomyopathy: a UK National Cohort Study.

Aims: Sudden cardiac death (SCD) is the most common mode of death in paediatric hypertrophic cardiomyopathy (HCM). This study describes the implant and programming strategies with clinical outcomes following implantable cardioverter-defibrillator (ICD) insertion in a well-characterized national paediatric HCM cohort.

Methods And Results: Data from 90 patients undergoing ICD insertion at a median age 13 (±3.

Ventricular fibromas in children, arrhythmia risk, and outcomes: A multicenter study.

Background: Although ventricular fibromas are rare, they are the second most common type of cardiac tumor in children. While histologically benign, they have a propensity to cause malignant arrhythmias, with cardiac arrest often being the first presentation.

Objective: The purpose of this study was to evaluate the arrhythmia risk and management strategies for pediatric ventricular fibromas.

Extraction of chronic pacing lead and angioplasty for complete superior baffle obstruction in complex congenital heart disease.

Laser lead extraction in adult patients with congenital heart disease is safe and effective. Baffle angioplasty for obstruction in patients with a Mustard procedure is well established. We describe a unique combined interventional and electrophysiological approach on a patient with superior baffle obstruction.

Correlations with operative anatomy of real time three-dimensional echocardiographic imaging of congenital aortic valvar stenosis.

Objective: To define the anatomic characteristics of the congenitally malformed and severely stenotic aortic valve using trans-thoracic real time three-dimensional echocardiography, and to compare and contrast this with the valvar morphology as seen at surgery.

Design: Prospective cross-sectional observational study.

Setting: Tertiary centre for paediatric cardiology.