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Right Side Accessory Pathway Mediated Cardiomyopathy Treated with Amiodarone: First Adult Case Report.

Anthony Costa¹, Ian Laxina², Fayaz Hakim³

¹Department of Internal Medicine, Henry Ford Genesys Hospital, Grand Blanc, MI.

American Journal of Therapeutics

|June 19, 2026

Summary

Pharmacologic reversal of accessory pathway-mediated cardiomyopathy is possible in adults. Amiodarone suppressed right-sided accessory pathway conduction, resolving severe cardiomyopathy and improving ejection fraction.

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Area of Science:

Cardiology
Electrophysiology
Pharmacology

Background:

Right-sided accessory pathways can cause ventricular dyssynchrony and reversible cardiomyopathy.
Catheter ablation is the standard treatment, but pharmacologic reversal in adults has not been previously reported.

Purpose of the Study:

To report the first case of complete pharmacologic reversal of dyssynchrony-mediated cardiomyopathy in an adult.

Main Methods:

A single-patient case report from a US community hospital.
Literature review confirmed no prior adult cases of complete pharmacologic reversal.
A 44-year-old male with Wolff-Parkinson-White syndrome and severe cardiomyopathy was treated with amiodarone after declining ablation.

Main Results:

Initiation of amiodarone led to resolution of right-sided preexcitation within 2 months.
Left ventricular ejection fraction (LVEF) improved from 10%-15% to 30%-35% in 2 months, and normalized to 60% by 4 months.
Left ventricular dilation resolved with amiodarone treatment.

Conclusions:

Amiodarone effectively suppressed antegrade accessory pathway conduction.
This suppression led to complete reversal of severe dyssynchrony-mediated cardiomyopathy in an adult who declined ablation.
Further studies are needed to confirm these findings.