SUCCESSFUL RADIOFREQUENCY CATHETER ABLATION OF AUTOMATIC ATRIAL TACHYCARDIA WITH REGRESSION OF THE CARDIOMYOPATHY PICTURE

Ectopic atrial tachycardia (EAT) is often refractory to pharmacologica l suppression, and if uncontrolled, it can lead to cardiomyopathy. Alt hough RF current catheter ablation therapy has been effective in elimi nating the arrhythmia, there is limited information, particularly in a dult patients with regard to the reversal of the tachycardia induced c ardiomyopathy. Four adult patients, 20-56 years of age, and a 6-year-o ld boy, were referred with refractory EAT. Four patients had heart fai lure and three had depressed LV function by echocardiographic criteria . All patients underwent electrophysiological study, and RF ablation w as successful in abolishing the arrhythmogenic foci. Of these, four we re located in the right atrium and one in the left atrium, and were id entified by recording of the earliest atrial activation. No complicati ons occurred. Termination of the EAT resulted in symptomatic improveme nt. Serial echocardiographic assessment of LV function indicated a sig nificant reversal of the cardiomyopathy picture with reduction in cham ber size and recovery in systolic function; indices of diastolic dysfu nction persisted in one patient. Chronic, uncontrolled EAT can cause t achycardia induced cardiomyopathy. The picture of the cardiomyopathy r esolves after elimination of the focus. RF ablation is both effective and safe, and may be considered as early therapy, particularly in pati ents with incessant EAT and ventricular dysfunction.