Tachycardia-Mediated Cardiomyopathy from Concealed Left-Sided AVRT with Complete Recovery Post-Ablation

Tachycardia mediated cardiomyopathy (TMC) is a reversible form of cardiomyopathy that results from persistent or incessant tachyarrhythmias. TMC may progress rapidly and present with symptoms of decompensated heart failure, cardiogenic shock, or multisystem organ dysfunction, sometimes in individuals with no prior cardiac history. Prompt recognition of the arrhythmia and early elimination of the underlying tachycardia are crucial, as restoration of sinus rhythm typically leads to complete or near-complete recovery of ventricular function [1]. Incessant supra-ventricular tachycardia (SVT) can be challenging to diagnose when patients present with advanced heart failure and multiorgan involvement and misinterpretation may delay definitive therapy. This case highlights an extreme presentation of incessant orthodromic AVRT causing biventricular failure, severe hepatic congestion and metabolic acidosis, with complete recovery following catheter ablation of a concealed left-sided accessory pathway.