Reversible cardiomyopathy after radiofrequency ablation of 30-year persistent atrial tachycardia

BMJ Case Rep. 2013 Dec 10:2013:bcr2013008727. doi: 10.1136/bcr-2013-008727.

Abstract

Tachycardia-induced cardiomyopathy (TIC) is a reversible form of the left ventricular (LV) systolic dysfunction and is believed to be a relatively acute process. We report a TIC case with a 30-year history of long-lasting persistent atrial tachycardia involving a 44-year-old man previously diagnosed with dilated cardiomyopathy and a low LV ejection fraction (LVEF) of 20%. ECG revealed atrial tachycardia at 110-120 bpm. He was hospitalised with a worsening heart failure. His clinical status was New York Heart Association functional class III, and echocardiography revealed LV dilation and an LVEF of 9%. A two-dimensional speckle-tracking strain measurement revealed LV mechanical dyssynchrony. He underwent radiofrequency ablation for atrial tachycardia. After restoring sinus rhythm, his cardiac symptoms improved immediately. The LV mechanical dyssynchrony decreased a week after ablation, without changes in the LV dilation or LVEF. Thereafter, the LV dilation and systolic function gradually improved, and atrial tachycardia and heart failure remained absent.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Atrial Fibrillation / pathology
  • Atrial Fibrillation / therapy*
  • Cardiomyopathies / etiology
  • Cardiomyopathies / physiopathology
  • Cardiomyopathies / therapy*
  • Cardiomyopathy, Dilated / physiopathology
  • Catheter Ablation*
  • Echocardiography
  • Heart Failure / etiology
  • Heart Failure / physiopathology
  • Heart Failure / therapy*
  • Heart Ventricles / physiopathology*
  • Humans
  • Male
  • Tachycardia, Supraventricular / pathology
  • Tachycardia, Supraventricular / therapy*
  • Ventricular Dysfunction, Left / etiology*
  • Ventricular Dysfunction, Left / physiopathology