To the Editor: Left atrial appendage (LAA) is one of the major sources of atrial arrhythmias in children.[1] But atrial tachycardia (AT) with an epicardial LAA origin is uncommon and usually arises from the base.[2] C...To the Editor: Left atrial appendage (LAA) is one of the major sources of atrial arrhythmias in children.[1] But atrial tachycardia (AT) with an epicardial LAA origin is uncommon and usually arises from the base.[2] Catheter ablation (CA) may be an important strategy for patients with atrial arrhythmia,[3] especially due to the LAA firing trigger.[4] Due to a large number of trabeculations and true epicardial location, endocardial CA in LAA may fail or even cause fatal tamponade.[2,5] The epicardial CA may be an alternative approach.[6] Because the LAA has a very thin wall and may be prone to perforation, caution should be taken when LAA ablation is performed,[4] even during an epicardial ablation. There may be recurrence of AT, and surgical left atrial appendectomy (SAE) may be required.展开更多
文摘To the Editor: Left atrial appendage (LAA) is one of the major sources of atrial arrhythmias in children.[1] But atrial tachycardia (AT) with an epicardial LAA origin is uncommon and usually arises from the base.[2] Catheter ablation (CA) may be an important strategy for patients with atrial arrhythmia,[3] especially due to the LAA firing trigger.[4] Due to a large number of trabeculations and true epicardial location, endocardial CA in LAA may fail or even cause fatal tamponade.[2,5] The epicardial CA may be an alternative approach.[6] Because the LAA has a very thin wall and may be prone to perforation, caution should be taken when LAA ablation is performed,[4] even during an epicardial ablation. There may be recurrence of AT, and surgical left atrial appendectomy (SAE) may be required.