Percutaneous catheter ablation of malignant, recurrent ventricular arrhythmia in a 10-month-old toddler

Catheter ablation is a safe and effective treatment modality for ventricular arrhythmia. The procedure is routine at many electrophysiology centers and is being undertaken ever earlier in patient care.1 However, the great majority of these procedures involve adults suffering from ischemic heart disease. Only 3 cases of transapical access catheter ablation of ventricular tachycardia (VT) have been reported in children of under 15 months of age.2, 3, 4 Such procedures are technically difficult because the catheters available are ill-suited to the small-sized heart of a child. We report a case of a 10-month-old toddler in whom life-saving ablation of VT was performed via a percutaneous femoral approach with transseptal access to the left ventricle (LV).