Successful radiofrequency ablation in a 3-month-old baby with permanent junctional reciprocating tachycardia: A new era in the treatment of incessant life-threatening arrhythmias in infants

We report our experience in treating a 3-month-old baby with accessory atrioventricular pathway by radiofrequency (RF) ablation. The baby was discovered to have incessant supraventricular tachycardia at 4 weeks of age. At that time, two-dimensional echocardiography showed dilated cardiomyopathy. Multiple direct current shocks and multipharmaceutical treatment failed to restore sinus rhythm. Electrophysiology study showed the presence of posteroseptal accessory pathway. Immediately after delivery of two RF pulses, successful ablation of the accessory pathway and complete atrioventricular (AV) block with good junctional escape rhythm were observed. Normal rhythm and AV conduction subsequently returned and all medical treatment was discontinued. To our best knowledge, this is the first case of successful treatment with RF ablation in early infancy.