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Catheter ablation treatment of supraventricular tachycardia-induced cardiomyopathy
A G Lashus1, C L Case, P C Gillette
1South 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.