Successful Catheter Ablation as a Substitute for Cardiac Resynchronization Therapy in Patient with an Accessory Pathway-induced Cardiomyopathy

• Published in: Internal Medicine Vol. 56; no. 16; pp. 2165 - 2169
• Main Authors: Nakabayashi, Keisuke, Sugiura, Ryo, Mizuno, Yusuke, Kato, Hiroko, Nakazawa, Naomi, Suzuki, Toshiaki, Saito, Hideki, Kawakatsu, Naomi, Goto, Masayuki, Isomura, Daichi, Okada, Hisayuki, Oka, Toshiaki
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.01.2017; Japan Science and Technology Agency
• Subjects: Ablation; accessory pathway-induced cardiomyopathy; Bundle-Branch Block - diagnosis; Cardiac arrhythmia; Cardiac Resynchronization Therapy - methods; Cardiomyopathy; Case Report; Catheter Ablation - methods; Catheters; Congestive heart failure; Contraction; Diagnosis, Differential; Dyspnea; Echocardiography; EKG; Electrocardiography; Heart failure; Heart Failure - etiology; Heart Failure - surgery; Humans; Internal medicine; Male; Medical instruments; Middle Aged; Radiofrequency ablation; radiofrequency catheter ablation; Respiration; right-sided pre-excitation syndrome; Ventricle; Wolff-Parkinson-White Syndrome - complications; Wolff-Parkinson-White Syndrome - diagnosis; Wolff-Parkinson-White Syndrome - surgery; radiofrequency catheter ablation; accessory pathway-induced cardiomyopathy; right-sided pre-excitation syndrome
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.8205-16

A 50-year-old man presented with exertional dyspnea and orthopnea. An electrocardiogram showed a delta wave and a wide QRS complex, similar to left bundle branch block. Cardiac echocardiography revealed diffuse severe hypokinesis and dyssynchrony. The patient was diagnosed with congestive heart failure. We considered that the patient's condition was caused by an accessory pathway-induced cardiomyopathy after heart failure compensation with guideline-oriented medical therapy. We therefore performed catheter ablation for right-sided pre-excitation syndrome as cardiac resynchronization therapy. The left ventricular dyssynchrony was resolved immediately after the procedure, and the patient's ventricular contraction improved, with a reduced cardiac volume at 6 months after the procedure-thus suggesting that the accessory pathway had affected the patient's cardiac function.