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J Thorac Cardiovasc Surg 2005;130:948-949
© 2005 The American Association for Thoracic Surgery

Brief Communication

Right ventricular outflow tract resection for treatment of refractory ventricular tachycardia in a 2-year-old child

S. Kanaan, MD * , K. Shamsuddin, MD, M. Silka, MD, W. Wells, MD

Department of Cardiothoracic Surgery, Children's Hospital of Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, Calif.

* Address for reprints: S. Kanaan, MD, Department of Cardiothoracic Surgery, University of Southern California, 1520 San Pablo St, HCC2 Suite 4300, Los Angeles, CA 90033 (Email: skanaan@earthlink.net).

The first 20% of the full text of this article appears below.

Ventricular tachycardia (VT) of right ventricular origin in young children might be due to Purkinje cell tumors, arrhythmogenic right ventricular dysplasia (ARVD), or Uhl's anomaly, or it might be idiopathic. 1 Go Surgical intervention has been used in adults when medical or catheter ablative therapy is ineffective. We describe a unique cause of VT of right ventricular outflow tract (RVOT) origin in a young child that was successfully managed with surgical resection.

Clinical Summary

A 2-year-old child presented with syncope and near-incessant VT at a rate of 270 beats/min. The tachycardia was notable for subtle irregularities in both cycle length and QRS morphology (Figure 1). However, all QRS complexes suggested an RVOT origin, with positive vectors in leads II, III, and aVF. Transthoracic echocardiography showed marked dilation of the RVOT, which was confirmed by means of cardiac magnetic resonance imaging. At electrophysiologic testing, the arrhythmia could not be terminated with overdrive pacing but did temporarily stop with adenosine. Activation mapping . . . [Full Text of this Article]






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