Key result
Radiofrequency catheter ablation of an anteroseptal accessory pathway in a patient with an LVEF of 20% resulted in normalization of left ventricular systolic function at 4 weeks.
Why the study?
Left ventricular systolic dysfunction is uncommon in non-sustained tachyarrhythmias, and the role of catheter ablation in asymptomatic patients remains unclear.
Does radiofrequency catheter ablation of an anteroseptal accessory pathway improve left ventricular systolic function in an asymptomatic patient with severe cardiomyopathy?
Case Report (n=1)
Does radiofrequency catheter ablation of an anteroseptal accessory pathway improve left ventricular systolic function in an asymptomatic patient with severe cardiomyopathy?
Catheter ablation of an asymptomatic anteroseptal accessory pathway can lead to normalization of severe left ventricular systolic dysfunction.
Clause 1 (Clinical meaning/caution): Suggests ablation may reverse cardiomyopathy induced by asymptomatic.
In patients with non-sustained tachyarrhythmias, left ventricular (LV) systolic dysfunction is uncommon. The role of catheter ablation (CA) in asymptomatic patients with tachyarrhythmia remains unclear. We report a 20-year-old patient without sustained tachyarrhythmia with a left ventricular ejection fraction of 20% who underwent radiofrequency catheter ablation (RFCA) of anteroseptal accessory pathway. She achieved normalization of left ventricular systolic function noted on echocardiography performed at 4 weeks post-ablation. Our case highlights significant improvement in LV systolic function after catheter ablation of an "asymptomatic" ventricular pre-excitation. Current guidelines do not endorse ablating asymptomatic patients, but careful follow-up with serial echocardiograms might be warranted. Prophylactic ablation of those patients with clear evidence of LV dyssynchrony or wide left bundle branch pattern and persistent pre-excitation is worth further consideration.
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Baqal et al. (2022) conducted a case report in Severe cardiomyopathy and asymptomatic ventricular pre-excitation (n=1). Radiofrequency catheter ablation (RFCA) was evaluated on Left ventricular systolic function. Radiofrequency catheter ablation of an anteroseptal accessory pathway in a patient with an LVEF of 20% resulted in normalization of left ventricular systolic function at 4 weeks.
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