Efficacy of Three-Dimensional Electroanatomic Mapping-Guided Minimally Invasive Transaxillary Atrial Appendage Resection for Focal Atrial Tachycardia Originating from the Atrial Appendage in Children - Report - MDSpire

Efficacy of Three-Dimensional Electroanatomic Mapping-Guided Minimally Invasive Transaxillary Atrial Appendage Resection for Focal Atrial Tachycardia Originating from the Atrial Appendage in Children

  • By

  • Wang, LuLu

  • Zhang, Weitao

  • Zhao, Liyun

  • Ai, Feng

  • Hu, Xiaosong

  • Li, Jiangzhen

  • Fan, Taibing

  • Song, Shubo

  • June 24, 2026

  • 0 min

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Effectiveness of Minimally Invasive Transaxillary Atrial Appendage Resection

Overview

This study evaluates the outcomes of minimally invasive transaxillary atrial appendage resection for pediatric focal atrial tachycardia (AAT) using Carto3 mapping. The results indicate successful immediate termination of tachycardia and restoration of sinus rhythm in all patients undergoing the procedure.

Background

Focal atrial tachycardia originating from the atrial appendage can lead to significant complications, including tachycardia-induced cardiomyopathy in children. This study explores a minimally invasive surgical approach.

Data Highlights

ParameterAppendage Resection Group (n=5)PFA Group (n=1)
Immediate AT Termination100%100%
Recurrence at Follow-up0%100%
Mean Age (years)10.28±3.49N/A
LVEF Improvement46.3±8.3% to 62.0±6.1%N/A
FS Improvement23.3±4.8% to 33.3±4.6%N/A
LVEDd Change47.3±3.5mm to 42.0±5.3mmN/A

Key Findings

  • 6 out of 27 pediatric patients were diagnosed with AAT.
  • 5 patients underwent minimally invasive transaxillary appendage resection, achieving immediate success.
  • All patients in the appendage resection group maintained sinus rhythm without recurrence at a median follow-up of 13 months.
  • In patients with tachycardia-induced cardiomyopathy, LVEF improved significantly post-surgery.
  • The single patient in the PFA group experienced recurrence of AT at 1 month post-procedure.

Clinical Implications

Minimally invasive transaxillary atrial appendage resection is evaluated for pediatric AAT, particularly for those with appendage tip origin or associated aneurysms.

Conclusion

The findings indicate that minimally invasive techniques guided by advanced mapping systems can provide outcomes for pediatric patients with atrial appendage tachycardia.

Related Resources & Content

  1. Pediatric Cardiology, Electrophysiological Assessment and Radiofrequency Catheter Ablation for Ectopic Atrial Tachycardia in Pediatric Patients, 2010
  2. Clinical Research in Cardiology, Ablation Therapy for the Short-Coupled Variant of Torsade de Pointes, 2021
  3. Clinical Research in Cardiology, Catheter Ablation of Persistent Ventricular Tachycardia from the Anterolateral Papillary Muscle Using Ablation Index Guidance, 2021
  4. Pediatric Cardiology, Tachyarrhythmias Following Surgery for Congenital Heart Disease in Pediatric and Young Adult Patients: Early and Late Onset Observations, 2022
  5. PACES/HRS expert consensus statement on the use of catheter ablation in children and patients with congenital heart disease, Heart Rhythm, 2016
  6. Supraventricular tachycardia in children, ScienceDirect, 2024
  7. Safety and feasibility of 3D‐electroanatomical mapping‐guided zero or near‐zero fluoroscopy catheter ablation for pediatric arrhythmias: Meta‐analysis, PMC, 2024
  8. Advanced Electroanatomic Mapping: Current and Emerging Approaches, PubMed, 2024
  9. Surgical and Ablation Therapies for Atrial Appendage Tachycardia in Children, ScienceDirect, 2024
  10. Catheter ablation for atrial tachycardia in pediatric patients: a single-center experience, Frontiers in Cardiovascular Medicine, 2024
  11. PACES/HRS expert consensus statement on catheter ablation in children
  12. Contemporary reviews on pediatric supraventricular tachycardia treatment options
  13. Safety and feasibility of 3D electroanatomical mapping in pediatric arrhythmias
  14. Advanced Electroanatomic Mapping: Current and Emerging Approaches - PubMed
  15. Surgical and Ablation Therapies for Atrial Appendage Tachycardia in Children - ScienceDirect
  16. Catheter ablation for atrial tachycardia in pediatric patients: a single-center experience
  17. First Report of Focal Atrial Tachycardia Originating From the Left Atrial Appendage in a 13-Year-Old Girl Treated Using the OPTRELL Multipolar Mapping Catheter - PubMed
  18. Unipolar Electrocautery Ablation via Minithoracotomy for Atrial Tachycardia Originating From the Right Atrial Appendage - PubMed
  19. Case report: Efficacy analysis of radiofrequency catheter ablation combined with atrial appendage resection for atrial tachycardia originating from the atrial appendage in children - PubMed

Original Source(s)

Efficacy of Three-Dimensional Electroanatomic Mapping-Guided Minimally Invasive Transaxillary Atrial Appendage Resection for Focal Atrial Tachycardia Originating from the Atrial Appendage in Children

  • by Wang, LuLu , Zhang, Weitao , Zhao, Liyun , Ai, Feng , Hu, Xiaosong , Li, Jiangzhen , Fan, Taibing , Song, Shubo

  • June 24, 2026

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