What is the time course of reversal of tachycardia-induced cardiomyopathy?

Abstract

Although the reversal of tachycardia-induced cardiomyopathy has been described previously, the time course of improvement in biventricular systolic function associated with tachycardia-induced cardiomyopathy has not been described. We present the case of a tachycardia-induced cardiomyopathy associated with atrial fibrillation. A transthoracic and transoesophageal echocardiogram performed the day prior to ablation revealed severe right and left ventricular (LV) systolic dysfunction. New York Heart Association Class IV symptoms and LV function were noted to improve 12 h after a successful catheter ablation. However, right ventricular (RV) systolic function remained depressed. A transthoracic echocardiogram demonstrated improvement of RV systolic function 5 months later. A 59-year-old male with a history of symptomatic paroxysmal atrial fibrillation (AF) refractory to dofetilide was referred for catheter ablation. Despite medical therapy, the patient had episodes of AF associated with New York Heart Association (NYHA) Class IV symptoms. Prior to ablation, a transthoracic echocardiogram (TTE) revealed a left ventricular ejection fraction (LVEF) of 25–30%. The patient underwent a successful wide area circumferential ablation of his pulmonary veins with confirmation of entrance and exit block and no inducible arrhythmias. On discharge …