Improvement of cardiac function and neurological remodeling in a patient with tachycardia-induced cardiomyopathy after catheter ablation.
Incessant ventricular tachycardia and long-standing ectopic beats lead to tachycardia-induced cardiomyopathy. Catheter ablation eliminates ventricular tachycardia and reverses left ventricular (LV) dysfunction. 201-Thallium ((201)Tl) scintigraphy demonstrates perfusion defects with ischemic cardiomyopathy. Reversible perfusion defects are observed even in non-ischemic cardiomyopathy, related to regional flow or metabolism derangements. 123-I-metaiodobezylguanidine ((123)I-MIBG) scintigraphy delineates regional cardiac sympathetic denervation and heterogeneity. We demonstrated the progression of tachycardia-induced cardiomyopathy in a patient with idiopathic LV outflow tract tachycardia using (201)Tl and (123)I-MIBG scintigraphic findings. Regional defects were reversed predominantly in the basal interventricular septal wall in (201)Tl scintigraphy and (123)I-MIBG scintigraphic findings. This report suggests that incessant ventricular tachycardia or long-standing ventricular ectopic beats may develop adverse myocardial remodeling and sympathetic neurological remodeling. Treatment with catheter ablation for tachycardia-induced cardiomyopathy can reverse sympathetic neurological remodeling as well as myocardial structural remodeling.
Omichi
Chikaya
C
Division of Cardiology, Cardiovascular Center, Kitahara Hospital, 1-7-23 Owada-cho, Hachioji, Tokyo 192-0045, Japan. omichi@kitaharahosp.com
Tanaka
Takeshi
T
Kakizawa
Yoshiko
Y
Yamada
Ayako
A
Ishii
Yasuhiro
Y
Nagashima
Hirotaka
H
Kanmatsuse
Katsuo
K
Endo
Masahiro
M
D000369:Aged, 80 and over; D005117:Cardiac Complexes, Premature / Q000150:complications; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*; D017115:Catheter Ablation; D006801:Humans; D007457:Iodine Radioisotopes; D008297:Male; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013564:Sympathetic Nervous System / Q000502:physiology*; D013610:Tachycardia / Q000150:complications* / Q000628:therapy; D013794:Thallium Radioisotopes; D020257:Ventricular Remodeling / Q000502:physiology*
D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D013794:Thallium Radioisotopes