[Radiofrequency ablation of an accessory left lateral pathway in an infant, using a transeptal approach]

We describe the case of a 4 month old child with supraventricular tachycardia detected on his second day of life, refractory to medical treatment, who was treated with radiofrequency catheter ablation of an accessory auriculoventricular pathway located on the left lateral wall. A venous femoral approach was used and the left atrium was entered through a patent foramen ovale, avoiding the risks of the arterial puncture and allowing us to administrate the radiofrequency current on the proper site. We discuss the potential risks of the therapeutic procedure in children and the benefits of the transeptal over the retrograde approaches for the treatment of left sided accessory pathways. Our conclusion is that catheter radiofrequency ablation of accessory pathways in children is possible with low risk, which can be diminished with the use of the transseptal approach when indicated.