Heart transplantation or ablation? – Tachycardia-induced cardiomyopathy – Case presentation
█ Case report
Borbély Attila, Clemens Marcell, Jenei Csaba, Daragó Andrea, Erdei Nóra, Hertelendi Zita, Fülöp Tibor, Csanádi Zoltán, Édes István
Debreceni Egyetem, Klinikai Központ, Kardiológiai Intézet, Kardiológiai és Szívsebészeti Klinika, Debrecen
A 44 year-old men, diagnosed with dilated cardiomyopathy 1.5 year ago, showing clinical signs of advanced heart failure was sent to our heart failure outpatient clinic to assess the need for ICD implantation and heart transplantation. ECG showed atrial tachycardia with high ventricular response. Holter ECG confirmed the presence of the atrial tachycardia in approximately 90% of the day. Electrophysiological examination identified the focus of the tachycardia on the anterior part of the left atria with alternating conduction via a fast and a slow pathway. Besides the successful ablation of the focus, ablation of the slow pathway was also performed due to the presence of „double ventricular response”. During patient follow-up – in stable sinus rhythm and on optimal heart failure drug therapy – the symptoms of the patient were completely resolved and the left ventricular systolic function normalized.