Resolution of severe cardiomyopathy after catheter ablation of an
anteroseptal accessory pathway: A case report
Abstract
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.