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.