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.