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June 20, 2026American Journal of TherapeuticsOpen Access

Amiodarone resolves preexcitation and normalizes LVEF to 60% in a patient with accessory pathway-mediated cardiomyopathy.

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Why the study?

Does amiodarone reverse severe dyssynchrony-mediated cardiomyopathy in adults with right-sided accessory pathways who decline ablation?

Population

1 adult with known Wolff-Parkinson-White presenting with palpitations, dyspnea, chest pain, and syncope…

Design

Case_report

Follow-up

4 months

Key result

Amiodarone therapy in a 44-year-old man with right-sided accessory pathway mediated cardiomyopathy led to resolution of preexcitation and normalization of LVEF from 10%-15% to 60% within 4 months.

Authors

ACAnthony CostaILIan LaxinaFHFayaz Hakim

Discussion

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Overview

Hypothesis-generating for amiodarone in accessory pathway cardiomyopathy; prospective studies needed before practice change.

Key Points

  • To report the pharmacologic reversal of cardiomyopathy caused by right-sided accessory pathways in an adult.
  • Single-patient case from a US community hospital
  • Literature review confirmed no prior cases
  • Patient treated with amiodarone after declining catheter ablation.
  • Patient's ejection fraction improved from 10%-15% to 60% over 4 months
  • Preexcitation resolved with amiodarone treatment
  • No other causes of cardiomyopathy identified.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

Does amiodarone reverse severe dyssynchrony-mediated cardiomyopathy in adults with right-sided accessory pathways who decline ablation?

P
Population
A 44-year-old man with Wolff-Parkinson-White syndrome and severe dyssynchrony-mediated cardiomyopathy (LVEF 10%-15%) who declined ablation.
I
Intervention
Amiodarone initiated and continued for 4 months, then discontinued and switched to flecainide.
O
Outcome
Resolution of preexcitation (loss of delta wave) and improvement in LVEF and LV dilation at 2 and 4 months.surrogate

Amiodarone successfully reversed severe dyssynchrony-mediated cardiomyopathy caused by a right-sided accessory pathway in an adult patient who declined catheter ablation.

Limitations

  • No cardiac MRI performed
  • No extended ambulatory rhythm monitoring
  • No formal electrophysiology study

Cite This Study

Costa et al. (2026) conducted a case report in Right Side Accessory Pathway Mediated Cardiomyopathy (n=1). Amiodarone was evaluated on Resolution of preexcitation and normalization of LVEF. Amiodarone therapy in a 44-year-old man with right-sided accessory pathway mediated cardiomyopathy led to resolution of preexcitation and normalization of LVEF from 10%-15% to 60% within 4 months.

synapsesocial.com/papers/6a3721e201fe431c25188933https://doi.org/10.1097/mjt.0000000000002161
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Also Consider

Synapse has enriched one closely related paper. Consider it for comparative context:

  1. 1Effect of Intravenous Amiodarone on Electrophysiologic Variables and on the Modes of Termination of Atrioventricular Reciprocating Tachycardia in Wolff-Parkinson-White Syndrome1999 · 18 citations