A Case of Heart Failure with Paroxysmal Atrial Flutter (pAFL) Ameliorated by Successful Radiofrequency Ablation (RFA)—Improvement of Biventricular Dysfunction by Radionuclide Ventriculography

概要

論文の詳細を見る
A 75-year-old man, who had been suffered from hypertrophic cardiomyopathy and ischemic heart disease admitted with non-tachycardia pAFL and heart failure. He was found to have severe biventricular diastolic dysfunction during sinus rhythm by radionuclide ventriculography. Common type 4:1 conduction flutter (rate 240 bpm) was revealed by halo catheter mapping and CARTO mapping of the electrophysiological study. Linear ablations at the isthmus terminated the AFL completely. The AFL could not be induced. No relevant changes were noticed for ventricular rate, and left ventricular (LV) ejection fraction (EF) (changed from 64% to 68%), whereas, right ventricular (RV) EF improved from 42% to 49% during sinus rhythm before and after the RFA by radionuclide ventriculography. Before and after the RFA at normal sinus rhythm, peak filling rate of LV and RV by radionuclide ventriculography increased from 161.4%/s to 204.8%/s, and from 111.1%/s to 174.8%/s, respectively. Diastolic parameters did not changed after the RFA by echocardiography. The RFA of pAFL is considered to improve heart failure symptoms, biventricular diastolic dysfunction, and RV systolic hypo-function. Radionuclide ventriculography appears to be useful for evaluating the therapeutic effects of RFA in patient with pAFL and biventricular dysfunction.