Resolution of severe cardiomyopathy after catheter ablation of an anteroseptal accessory pathway: A case report

In patients with non‐sustained tachyarrhythmias, left ventricular (LV) systolic dysfunction is uncommon. The role of catheter ablation (CA) in asymptomatic patients with tachyarrhythmia remains unclear. We report a 20‐year‐old patient without sustained tachyarrhythmia with a left ventricular ejection fraction of 20% who underwent radiofrequency catheter ablation (RFCA) of anteroseptal accessory pathway. She achieved normalization of left ventricular systolic function noted on echocardiography performed at 4 weeks post‐ablation. Our case highlights significant improvement in LV systolic function after catheter ablation of an “asymptomatic” ventricular pre‐excitation. Current guidelines do not endorse ablating asymptomatic patients, but careful follow‐up with serial echocardiograms might be warranted. Prophylactic ablation of those patients with clear evidence of LV dyssynchrony or wide left bundle branch pattern and persistent pre‐excitation is worth further consideration.