Epicardial ablation of ventricular tachycardia in a child on venoarterial extracorporeal membrane oxygenation

Epicardial catheter ablation has been demonstrated to be safe and effective in adults, but there are limited reports in the pediatric population. We report the epicardial ablation of an incessant, hemodynamically compromising ventricular tachycardia in a 13-month-old patient on venoarterial extracorporeal membrane oxygenation. The procedure resulted in elimination of tachycardia substrate with improved cardiac size and function at follow-up. Despite a reasonable long-term outcome in this child, epicardial ablation in young patients should be reserved for similarly dire circumstances.