[Myocardial dysfunction secondary to persistent tachycardia]

Area of Science:

• Cardiology
• Electrophysiology
• Cardiac Surgery

Context:

• Incessant atrioventricular tachycardia (IAVT) is a rare arrhythmia.
• Patients with IAVT often present with ventricular dysfunction.
• Drug-refractory IAVT poses a significant clinical challenge.

Purpose:

• To evaluate the impact of surgical ablation on ventricular dysfunction in patients with IAVT.
• To assess the efficacy of surgical intervention in managing drug-refractory IAVT.
• To demonstrate the reversibility of myocardial dysfunction following successful arrhythmia ablation.

Summary:

• This study investigated five patients with IAVT and ventricular dysfunction who underwent surgical ablation.
• Preoperative assessments revealed persistent tachycardia, impaired ejection fraction, and enlarged left ventricular diastolic diameter.
• Electrophysiologic study identified a postero-septal anomalous atrioventricular pathway.
• Post-ablation, all patients achieved asymptomatic sinus rhythm with significant improvement in ejection fraction and normalization of ventricular dimensions.

Impact:

• Surgical ablation of anomalous atrioventricular pathways is a highly effective treatment for IAVT.
• Myocardial dysfunction associated with IAVT is reversible after successful ablation.
• This intervention offers a definitive solution for patients refractory to antiarrhythmic drugs.