Charge density mapping in a pediatric patient with symptomatic runs of ectopic atrial tachycardia

Ectopic atrial tachycardia (AT) poses a notable challenge in pediatric cardiology, often requiring precise localization for optimal treatment. Its incidence is relatively low, affecting 3.7%–5.7% of children undergoing electrophysiological studies.1 While catheter ablation complements pharmacological therapy, achieving a high success rate of approximately 90%, there is room for enhancement.1 A challenge lies in mapping and ablating transient episodes of AT. Recent innovations in mapping technologies, notably charge density mapping, have shown promise in providing precise single-beat noncontact mapping of transient AT in adult patients.2,3 This mapping technique uses individualized anatomy of a heart chamber, created by ultrasound crystals that are integrated in a basket catheter, with subsequent visualization of recorded cardiac dipoles.4 This article explores a unique case with short runs of ectopic AT, demonstrating the efficacy of single-beat noncontact mapping using charge density mapping in a pediatric patient.