Focal atrial tachycardia arising from left superior pulmonary vein in a pediatric patient, safely treated by pulsed-field ablation.

INTRODUCTION: We describe the first case of the use of pulsed-field ablation (PFA) to treat focal atrial tachycardia (FAT) in a pediatric patient. METHODS: An 11-year-old girl with obesity was referred to our center for ablation of incessant atrial tachycardia. The earliest atrial activation was shown to be present in the left superior pulmonary vein. Radiofrequency ablation of FAT seems to be associated with a lower success rate and, especially, with a higher complication rate than in adult patients. RESULTS: We performed ablation by means of a novel nonthermal energy source (PFA) that is able to reduce the risk of complications due to injury to anatomic structures surrounding the heart. After the first application, stable sinus rhythm was restored. CONCLUSIONS: PFA can be used to treat FAT arising from pulmonary veins in young children as a good alternative to RFA ablation, thereby reducing the risk of potential procedure-related complications.