Catheter ablation in a teenager with two arrythmias and tachycardiomyopathy – rare clinical presentation with rapid symptoms development

Supraventricular tachycardia has several clinical manifestations, one of the most dangerous being tachycardiomyopathy, which directs the clinical approach towards catheter ablation rather than pharmacotherapy. Both an accessory pathway and focal atrial tachycardia alone are listed as risk factors for tachycardiomyopathy development. We present a case of a 17 year-old adolescent with atrioventricular re entrant tachycardia and focal atrial tachycardia, which resulted in occurrence of arrhythmia-related cardiomyopathy, and which were successfully treated with radiofrequency ablation during one procedure. All of the arrhythmia and heart failure related symptoms resolved within weeks after the catheter ablation, which confirmed these two arrhythmias as the reason for heart remodelling. Rapid onset of symptoms requires fast action, and the electrophysiological study (EPS) with potential catheter ablation should not be postponed.