Pulmonary damage following right ventricular outflow tachycardia ablation in a child: When electroanatomical mapping isn't good enough

Neha Bansal, Daisuke Kobayashi, Peter P. Karpawich

Research output: Contribution to journalArticle

Abstract

A 14-year-old female was referred for severe pulmonary valve insufficiency after undergoing radiofrequency ablation for a right ventricular outflow tract tachycardia that originated in the proximal pulmonary artery at 10 years of age. Clinical records indicated that ablation was guided solely by electrograms and electroanatomical mapping. Due to myocardial tissue extensions, mapping failed to identify the level of the pulmonary valve annulus, which resulted in delivery of energy on the valve proper and into the pulmonary artery. She developed severe pulmonary valve insufficiency and moderate proximal pulmonary artery stenosis necessitating intravascular stent placement 4 years later with an associated transcatheter valve. Although the nonfluoroscopic approach during ablation has gained wide acceptance for use in children, this report highlights the benefits of adjunctive imaging to identify the precise location of the pulmonary valve when ablation therapy is contemplated in the right ventricle outflow tract.

Original languageEnglish (US)
Pages (from-to)561-565
Number of pages5
JournalPACE - Pacing and Clinical Electrophysiology
Volume41
Issue number5
DOIs
Publication statusPublished - May 2018
Externally publishedYes

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Keywords

  • electroanatomical mapping
  • nonfluoroscopy ablation
  • pulmonary artery
  • radiofrequency ablation
  • right ventricular outflow tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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