Treatment of ventricular tachycardia-induced cardiomyopathy by transcatheter radiofrequency ablation.

Catheter ablation of ventricular tachycardia was successfully performed in a patient with dilated cardiomyopathy (ejection fraction 38%) and a long history of repetitive palpitations. Holter monitoring showed ventricular tachycardia that had a left bundle branch block QRS configuration with inferior axis deviation and was present for about one third of the daytime hours. At electrophysiological testing, ventricular tachycardia was reproduced by isoprenaline infusion. Radiofrequency energy delivered to the right ventricular outflow tract was successful at preventing the induction of ventricular tachycardia. Left ventricular ejection fraction had improved from 38% to 48% one month after ablation. During the follow up period of one year the patient remained free from arrhythmia on no medication. The ejection fraction was 61% one year after ablation. This report confirms that dilated cardiomyopathy can be induced by ventricular tachycardia and demonstrates that dilated cardiomyopathy can be reversed if the tachycardia is abolished by radiofrequency catheter ablation.