Follow-up
In the following days, with the tachycardia successful control with the
emergency ablation, the patient improved gradually with EF increase from
the initial 10% to 28% to 30% and eventually normalized at 58% with
no residual hypokinesis. However, intermittent preexcitation was still
documented on his continuous ECG monitoring, but no episode of
tachycardia was recorded. Under a more stable condition, the patient had
PCPS removed and was wind off the ventilators. A cardiac MRI was then
taken to rule out acute myocarditis, which showed a mildly dilated left
ventricle with no sign of acute inflammation. A second electrophysiology
study was then performed, and we completely ablated the accessory
pathway without any complication. The patient was discharged and
scheduled for a revisit at our outpatient clinic. After one year, he
presented with an episode of palpitation with documented narrow QRS
tachycardia. The third procedure was consulted for him, during which the
supraventricular tachycardia was revealed to be focal atrial
tachycardia. Focal ablation over the origin of the SVT at the high
crista terminalis terminates the tachycardia and renders it uninducible.