Key result
Radiofrequency catheter ablation of an anteroseptal accessory pathway in a 20-year-old female with an LVEF of 20% led to normalization of left ventricular systolic function at 4 weeks.
Why the study?
In patients with non-sustained tachyarrhythmias, LV systolic dysfunction is uncommon, and the role of catheter ablation in asymptomatic patients with tachyarrhythmia remains unclear.
Does radiofrequency catheter ablation improve left ventricular systolic function in a patient with asymptomatic ventricular preexcitation and severe cardiomyopathy?
Case Report (n=1)
Does radiofrequency catheter ablation improve left ventricular systolic function in a patient with asymptomatic ventricular preexcitation and severe cardiomyopathy?
Catheter ablation of an asymptomatic anteroseptal accessory pathway can lead to the resolution of severe left ventricular systolic dysfunction.
Suggests ablation may reverse cardiomyopathy in asymptomatic preexcitation; leaves open whether this hypothesis.
Background: 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. Case presentation: 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 four weeks post-ablation. Conclusions: Our case highlights significant improvement in LV systolic function after catheter ablation of an “asymptomatic” ventricular preexcitation. 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 preexcitation is worth further consideration.
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Baqal et al. (2022) conducted a case report in Severe cardiomyopathy with asymptomatic ventricular preexcitation (n=1). Radiofrequency catheter ablation (RFCA) of anteroseptal accessory pathway was evaluated on Left ventricular systolic function. Radiofrequency catheter ablation of an anteroseptal accessory pathway in a 20-year-old female with an LVEF of 20% led to normalization of left ventricular systolic function at 4 weeks.
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