Left ventricular dysfunction induced by monomorphic ventricular arrhythmias:: Large improvement in ventricular function after radiofrequency ablation of the arrhythmic source

Left ventricular systolic dysfunction related to ventricular arrhythmias is a relatively poorly understood entity. To increase our knowledge base, we describe 5 patients in whom the link between ventricular dysfunction and ventricular arrhythmia was unequivocally established. All patients had repetitive monomorphic ventricular arrhythmias and left ventricular systolic dysfunction (ejection fraction <= 40% and end-diastolic size >= 55 mm). The arrhythmogenic source was identified by electrophysiological study (right ventricle in 2 patients, left ventricle in 2, and left sinus of Valsalva in one), and was eliminated in all patients by radiofrequency catheter ablation. At 7 +/- 2 months post-ablation, large improvements were seen in left ventricular function and remodeling (ejection fraction >= 50% and end-diastolic size >= 51 mm in all cases), with no recurrence of arrhythmia during follow-up (10-69 months). This finding confirms that recurring ventricular arrhythmias can induce left ventricular dysfunction which may be reversible after ablation.