Radiofrequency catheter ablation for ventricular tachycardia using robotic magnetic navigation technology in a teenager after surgery of congenital heart disease and transcatheter closure of ventricular septal defect using an occluder: a case report

Abstract

Introduction. The case report describes radiofrequency ablation of ventricular tachycardia (VT) using robotic magnetic navigation (RMN) in a teenager after surgery of congenital heart disease (CHD) and transcatheter closure of ventricular septal defect (VSD) using an occluder.Short description. The 16-year-old female patient was operated on in 2005 for CHD. In 2018, the patient underwent resection of ascending aortic sub-valvular membrane, followed by transcatheter closure of VSD with an occluder. After surgery, VT of 294 bpm was documented, which required an emergency hospitalization. Decision was taken to perform a radiofrequency ablation (RFA) using RMN. RFA was performed from the pulmonary artery valve through the scar to upper occluder edge spreading to tricuspid valve. After procedure, VT paroxysms were not induced with all pacing types. According to ECG series and 24-hour Holter monitoring on the 2nd day after surgery, VT episodes were not recorded. During the 6-month follow-up period, VT episodes were not registered without taking antiarrhythmic drugs.Discussion. This case report demonstrates the effectiveness of using RMN system for VT ablation in a teenager with CHD, who underwent open surgical interventions and transcatheter VSD closure using an occluder.