Double Ventricular Responses Leading to Reversible Cardiomyopathy as Late Complication after Slow-Pathway Ablation

Area of Science:

• Cardiology
• Electrophysiology
• Cardiac Arrhythmias

Background:

• Double ventricular response is a rare arrhythmia caused by simultaneous antegrade conduction through both fast and slow pathways of the atrioventricular (AV) node.
• This arrhythmia can potentially lead to cardiomyopathy, a disease of the heart muscle.
• Reversible cardiomyopathy resulting from double ventricular responses after slow pathway ablation has not been previously reported.

Purpose of the Study:

• To report a unique case of cardiomyopathy that developed secondary to double ventricular responses.
• To highlight the potential for reversible cardiomyopathy in patients with a history of slow pathway ablation.

Main Methods:

• Case report detailing a patient's clinical presentation, electrophysiological findings, and long-term follow-up.
• Review of relevant literature on double ventricular responses and associated cardiomyopathies.

Main Results:

• The patient developed double ventricular responses after slow pathway ablation.
• Cardiomyopathy was diagnosed 5 years post-ablation, showing a potential link between the arrhythmia and cardiac dysfunction.
• The cardiomyopathy demonstrated reversibility, suggesting a dynamic relationship with the underlying electrophysiological substrate.

Conclusions:

• Double ventricular response can lead to a unique form of reversible cardiomyopathy, even years after successful ablation.
• This case underscores the importance of long-term monitoring for cardiac function in patients with a history of complex arrhythmias and ablation procedures.