Arrhythmia close to the right phrenic nerve

[dzavala73]

I have a 5 years old son who was admitted to the ICU when he was 2 yrs old, with generalized edema due to tachycardia-induced heart failure.
His heart rhythm was controlled with amiodarone and propanolol and after a few months his heart went back to almost normal.
After a couple years we quit amiodarone and kept just the propanolol. Even though he had permanent ectopic activity and non sustained tachycardia episodes while on propanolol, his heart was Ok for more than a year.
Recently his Echo showed his heart was mild dilated and he had a low normal ejection fraction, so his doctor recommended an ablation.
The ablation was done 2 weeks ago without success. He has an ectopic focus on the right atrium, close to phrenic nerve, which is very sensitive to adrenaline.
The EP tried several times to get rid of it with cryoablation but he could not succeed.
Since then, my son has been given atenolol. He started with 12.5 mg twice a day and now he is taking 37.5 mg twice a day. However, his ectopic activity and tachycardia are increasing.
We need to get full control of his heart rhythm to give it the chance to recover his normal size and function. The last thing we would like to do is to get back to amiodarone so please help us with the following questions:
1. Are there any other drugs available rather than amiodarone that could help him to control his rhythm? If atenolol did not work should we try propranolol again or it is almost the same? What about flecainide?
2. Now that we know the exact position of the ectopic focus, are there EPs specialized in the ablation of specific types of arrhythmias, such as those originated near the right phrenic nerve, that could make a second ablation worth it? Our EP says he would like for him to wait at least a couple years before trying another ablation. He says that for this kind of arrhythmias there are some “tricks” that can be done when you are older.
Thanks for your help!

[spade22]

Hi,  I'm sorry your son has these problems.

This forum is answered by patients (occasionally a doctor will answer questions) and because of the specific  questions in your post, it is very likely  that no one here will be able to provide you with meaningful answers.  There is an expert forum on medhelp on heart disease which is answered by a doctor but only two questions a day are allowed.  You might try posting there.

Good luck!

[dzavala73]

Thanks for your help!