Cardiomyopathy induced by pulmonary vein tachycardia cured by catheter ablation.

BACKGROUND

A 51-year-old male was referred for consideration for heart transplantation because of recently diagnosed congestive heart failure refractory to medical therapy. Previous echocardiography demonstrated a left ventricular ejection fraction of approximately 15% with global hypokinesia. Coronary angiography did not reveal any clinically significant obstructive coronary artery disease and an electrocardiogram documented atrial fibrillation with a rapid ventricular rate of 130 beats/min. Other laboratory tests including thyroid function test were unremarkable. The patient's main complaints were dyspnea on exertion, and orthopnea with minimal palpitations.

INVESTIGATIONS

Physical examination, laboratory testing, electrocardiography, Holter monitoring, chest radiography, transthoracic echocardiography, transesophageal echocardiography, coronary angiogram, and electrophysiologic study with catheter ablation.

DIAGNOSIS

Cardiomyopathy resulting from pulmonary vein tachycardia.

MANAGEMENT

Catheter-based radiofrequency ablation of the focus of pulmonary vein tachycardia.