18-year-old man with cardiomyopathy resulting from isolated left ventricular non-compaction and atrial fibrillation diagnosed for the first time — difficult choices and therapeutic decisions

Abstract

The article presents the case of an 18-year-old man who underwent ablation with the use of alternating electric current with radio frequency of the accessory pathway due to the Wolff-Parkinson-White syndrome, was diagnosed with cardiomyopathy resulting from left ventricular non-compaction and was admitted to the Cardiac Intensive Care Unit as a result of his first bout of atrial fibrillation. After the first pharmacological cardioversion proved to be ineffective, electrical cardioversion was implemented, successfully restoring sinus heart rhythm. Further difficult decisions regarding the patient’s drug therapy will have to be made, especially in the area of oral anticoagulants. After the analysis of the clinical picture, laboratory tests and echocardiography, the decision was made not to introduce oral anticoagulants and continue administration of the acetylsalicylic acid. There are no clear criteria and guidelines regarding the use of oral anticoagulant therapy in the case of cardiomyopathy resulting from left ventricular non-compaction and there are various views on the need of implementing such therapy after the first episode of arrhythmia and on how long it should last, therefore this case needs to be analyzed and discussed.