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Young patient with dilatative cardiomyopathy and paroxysmal atrial fibrilation(PAF) – ablation therapy

Luka Katić ; School of Medicine University of Zagreb
Luka Županović ; School of Medicine University of Zagreb
Vedran Velagić ; University Hospital Centre Zagreb

Puni tekst: engleski, pdf (103 KB) str. 0-0 preuzimanja: 12* citiraj
APA 6th Edition
Katić, L., Županović, L. i Velagić, V. (2019). Young patient with dilatative cardiomyopathy and paroxysmal atrial fibrilation(PAF) – ablation therapy. Liječnički vjesnik, 141 (suppl.1), 0-0. Preuzeto s https://hrcak.srce.hr/225340
MLA 8th Edition
Katić, Luka, et al. "Young patient with dilatative cardiomyopathy and paroxysmal atrial fibrilation(PAF) – ablation therapy." Liječnički vjesnik, vol. 141, br. suppl.1, 2019, str. 0-0. https://hrcak.srce.hr/225340. Citirano 15.12.2019.
Chicago 17th Edition
Katić, Luka, Luka Županović i Vedran Velagić. "Young patient with dilatative cardiomyopathy and paroxysmal atrial fibrilation(PAF) – ablation therapy." Liječnički vjesnik 141, br. suppl.1 (2019): 0-0. https://hrcak.srce.hr/225340
Harvard
Katić, L., Županović, L., i Velagić, V. (2019). 'Young patient with dilatative cardiomyopathy and paroxysmal atrial fibrilation(PAF) – ablation therapy', Liječnički vjesnik, 141(suppl.1), str. 0-0. Preuzeto s: https://hrcak.srce.hr/225340 (Datum pristupa: 15.12.2019.)
Vancouver
Katić L, Županović L, Velagić V. Young patient with dilatative cardiomyopathy and paroxysmal atrial fibrilation(PAF) – ablation therapy. Liječnički vjesnik [Internet]. 2019 [pristupljeno 15.12.2019.];141(suppl.1):0-0. Dostupno na: https://hrcak.srce.hr/225340
IEEE
L. Katić, L. Županović i V. Velagić, "Young patient with dilatative cardiomyopathy and paroxysmal atrial fibrilation(PAF) – ablation therapy", Liječnički vjesnik, vol.141, br. suppl.1, str. 0-0, 2019. [Online]. Dostupno na: https://hrcak.srce.hr/225340. [Citirano: 15.12.2019.]

Sažetak
We report a case of patient with dilatative cardiomyopathy, implanted cardioverter defibrillator with inapropriate shocks due to fast paroxysmal atrial fibrilation treated by cryoablation of pulmonary veins. A 43 year old man was diagnosed with acute heart failure (HF) and atrial fibrillation (AF) in 07.2016. At first, he was treated with diuretic and inotrope therapy and later on converted to sinus rhythm with amiodarone.Echocardiography showed dilatative cardiomyopathy with low ejection fraction of 20%. Coronarography ruled out ischemic disease. Spiroergometry established moderly decreased functional capacity, often irregular non-sustained ventricular tachycardia. Holter ECG showed a lot of episodes of atrial fibrillation. Single chamber cardioverter defibrillator (ICD) was implanted for primary prevention of sudden cardiac death. Later on patient presented with inappropriate ICD shocks due to fast AF despite amiodarone therapy. Therefore, pulmonary vein isolation (PVI) was indicated. 4/2018 TOE excluded LAA thrombus and successful cryoablation of all pulmonary veins was performed (Picture 1). After PVI, patient did not experience further AF symptoms which was confirmed in the ICD follow up (Picture 2). Complete reduction of AF burden was verified. Furthermore, HF symptoms improved and patient was in NYHA I-II class. Ultrasound confirmed positive remodeling of LV and EF increased to 40% with marked decrease of proBNP. Amiodarone therapy was abolished. Ablation of AF prevented further inadequate shocks of ICD and increased ejection fraction (EF) from 20% to 40%. Therefore, at least partly, heart failure was tachycardia mediated (tachycardiomiopathy). Ablation and reduction of AF burden in this case has direct mortality benefit.

Ključne riječi
ablation, dilatative cardiomyopathy, paroxysmal atrial fibrilation

Hrčak ID: 225340

URI
https://hrcak.srce.hr/225340

Posjeta: 39 *