Focal ablation of chaotic atrial rhythm in an infant with cardiomyopathy

Ablation of Chaotic Atrial Rhythm. Chaotic atrial rhythm in infants has bee n defined similar to multifocal atrial tachycardia in adults, implying a mu ltifocal etiology, However, its ECG appearance resembles atrial fibrillatio n, which sometimes has a unifocal ectopic mechanism amenable to catheter ab lation, Curative focal radiofrequency ablation was performed in a 4-month-o ld infant with chaotic atrial rhythm and dilated cardiomyopathy, Left ventr icular function subsequently returned to normal. Reversibility of associate d cardiomyopathy supports aggressive rhythm management of chaotic atrial rh ythm. In this patient, the unifocal origin allows insight into the pathophy siology of the rhythm and demonstrates the potential utility of catheter ab lation for refractory cases.