Successful Cryoablation of Ventricular Tachycardia in a Patient With a Prior Fontan Operation

Area of Science:

• Cardiology
• Electrophysiology
• Pediatric Cardiac Surgery

Background:

• Supraventricular and ventricular tachycardia are significant late complications following the Fontan operation in single ventricle patients.
• Ablation for ventricular tachycardia involving the His-Purkinje system poses a high risk of atrioventricular block.

Observation:

• A single patient with a single ventricle post-Fontan operation presented with ventricular tachycardia involving the His-Purkinje system.
• This patient was considered high-risk for developing atrioventricular block if traditional ablation methods were used.

Findings:

• Three-dimensional electroanatomic mapping-guided cryoablation was successfully performed.
• The procedure was achieved without inducing atrioventricular block.
• The patient experienced long-term freedom from tachycardia recurrence.

Implications:

• This technique offers a potentially safer alternative for treating complex ventricular tachycardia in Fontan patients.
• Minimizing the risk of atrioventricular block is crucial for long-term outcomes in this vulnerable population.
• Further research may validate this approach for broader clinical application in single ventricle survivors.