Radiofrequency Ablation of Ectopic Atrial Tachycardia

Ectopic Atrial Tachycardia (EAT) is a relatively rare arrhythmia in the pediatric population. It is defined by a run of more than 3 premature atrial contractions together. In EAT, the arrhythmia tends to increase in rate over a period of time and then slows down gradually to a normal rhythm. Ectopic Atrial Tachycardia (EAT) is mostly encountered in patients with structurally normal hearts however, occasionally physicians do observe this type of disorder in children following surgery for congenital heart defects. Current reports suggest that EAT occurs in approximately 1 in 10,000 children (Hamilton, 2002).

Children with EAT usually present with a multitude of symptoms. The most common symptoms associated with pediatric EAT are palpitations, chest pain, lightheadedness, presyncope, and dyspnea. Other symptoms can include exercise intolerance and congestive heart failure. These are usually late manifestations. In the patients with tachycardia induced CM, the time of development of CM is dependent on the rate and duration of the tachycardia however, in most cases, dilation is present upon diagnosis. This CM can be reversed with successful treatment of the arrhythmia.

The treatment for chronic EAT includes medications such as adenosine and for difficult to control cases, Radiofrequency Ablation (RFA). RF ablation has been successful in curing EAT, with success rates ranging from 75-100%. It has been shown that the complication rates are similar to other RF ablation procedures, with a higher risk of recurrence (Hamilton, 2002).

At Children's Healthcare of Atlanta, the cardiac catheterization lab performs approximately 10 Radiofrequency ablations for EAT each year. The goal of this retrospective review is to assess the frequency of recurrence of the EAT among a subset of patients receiving treatment between August 1992 - August 2003