Catheter ablation treatment of supraventricular tachycardia-induced cardiomyopathy
A. G. Lashus, C. L. Case and P. C. Gillette
South Carolina Children's Heart Center, Medical University of South Carolina, Charleston, USA.
OBJECTIVE: To investigate the efficacy of radiofrequency catheter ablation
(RFCA) as an alternative nonpharmacological therapy for tachycardia-induced
cardiomyopathy. DESIGN: A retrospective study of 8 pediatric patients (age
range, 10 months to 21 years) who underwent RFCA for an incessant
supraventricular tachycardia-induced cardiomyopathy. A patient's
tachycardia was considered incessant if the tachycardia was present more
than 75% of the time. The left ventricular shortening fraction, as measured
by echocardiography, before and after ablation, was used as the index of
cardiac function. Cardiomyopathy was defined as a left ventricular
shortening fraction of 28% or less. RESULTS: Following RFCA, 7 patients had
total resolution of their tachycardia and were discharged from the hospital
with no antiarrhythmic medications. The remaining patient's tachycardia was
modified by the catheter ablation and was subsequently controlled with
flecainide acetate. With follow-up ranging from 9 months to 3 years, all
patients have normal cardiac function as documented by echocardiography. No
significant morbidity resulted from the catheter ablations. CONCLUSIONS:
Tachycardia-induced cardiomyopathy is amenable to "curative" therapy with
RFCA. Ventricular function returns to normal after the successful catheter
ablation procedure.
