Advertisement

Heart and Vessels

, Volume 28, Issue 6, pp 802–807 | Cite as

Improvement in non-tachycardia-induced cardiac failure after radiofrequency catheter ablation in a child with a right-sided accessory pathway

  • Hideo Fukunaga
  • Katsumi Akimoto
  • Takeshi Furukawa
  • Ken Takahashi
  • Masahiko Kishiro
  • Toshiaki Shimizu
  • Hiroshi Kamiyama
  • Naokata SumitomoEmail author
Case Report

Abstract

A 6-year-old boy was referred for an evaluation of intolerance to physical activity at his elementary school. The patient had no episodes of palpitations. He was diagnosed as Wolff-Parkinson-White syndrome with a right-sided accessory pathway (AP) and dilated cardiomyopathy (DCM). Ventricular dyskinesis was detected mostly in the ventricular septum. Because the asynchronous septal motion caused by pre-excitation through a right-sided AP might deteriorate his cardiac function, he underwent an AP ablation, after which the asynchronous ventricular wall motion disappeared and the wall thickness improved. We suggest that an AP ablation may be the treatment of first priority in patients who have DCM-like dyskinesis even without sustained tachyarrhythmias.

Keywords

Child Wolff-Parkinson-White syndrome Dilated cardiomyopathy Accessory pathway Dyskinesis 

Notes

Acknowledgments

The authors thank Mr. John Martin for his linguistic assistance with this article.

Conflict of interest

None declared.

References

  1. 1.
    Klein GJ, Yee R, Sharma AD (1989) Longitudinal electrophysiologic assessment of asymptomatic patients with the Wolff-Parkinson-White electrocardiographic pattern. N Engl J Med 320:1229–1233PubMedCrossRefGoogle Scholar
  2. 2.
    Hishida H, Sotobata I, Koike Y, Okumura M, Mizuno Y (1976) Echocardiographic patterns of ventricular contraction in the Wolff-Parkinson-White syndrome. Circulation 54:567–570PubMedCrossRefGoogle Scholar
  3. 3.
    DeMaria AN, Vera Z, Neumann A, Mason DT (1976) Alterations in ventricular contraction pattern in the Wolff-Parkinson-White syndrome. Detection by echocardiography. Circulation 53:249–257PubMedCrossRefGoogle Scholar
  4. 4.
    Shan Q, Jin Y, Cao K (2007) Reversible left ventricular dyssynchrony and dysfunction resulting from right ventricular pre-excitation. Europace 9:697–701PubMedCrossRefGoogle Scholar
  5. 5.
    Nelson GS, Curry CW, Wyman BT, Kramer A, Declerck J, Talbot M, Douglas MR, Berger RD, McVeigh ER, Kass DA (2000) Predictors of systolic augmentation from left ventricular preexcitation in patients with dilated cardiomyopathy and intraventricular conduction delay. Circulation 101:2703–2709PubMedCrossRefGoogle Scholar
  6. 6.
    Udink ten Cate FE, Kruessell MA, Wagner K, Trieschmann U, Emmel M, Brockmeier K, Sreeram N (2010) Dilated cardiomyopathy in children with ventricular preexcitation: the location of the accessory pathway is predictive of this association. J Electrocardiol 43:146–154PubMedCrossRefGoogle Scholar
  7. 7.
    Tomaske M, Janousek J, Razek V, Gebauer RA, Tomek V, Hindricks G, Knirsch W, Bauersfeld U (2008) Adverse effects of Wolff-Parkinson-White syndrome with right septal or posteroseptal accessory pathways on cardiac function. Europace 10:181–189PubMedCrossRefGoogle Scholar
  8. 8.
    Cadrin-Tourigny J, Fournier A, Andelfinger G, Khairy P (2008) Severe left ventricular dysfunction in infants with ventricular preexcitation. Heart Rhythm 5:1320–1322PubMedCrossRefGoogle Scholar
  9. 9.
    Cai Q, Shuraih M, Nagueh SF (2012) The use of echocardiography in Wolff-Parkinson-White syndrome. Int J Cardiovasc Imaging 28:725–734PubMedCrossRefGoogle Scholar
  10. 10.
    Iwasaku T, Hirooka K, Taniguchi T, Hamano G, Utsunomiya Y, Nakagawa A, Koide M, Ishizu T, Yamato M, Sasaki N, Yamamoto H, Kawaguchi Y, Mizuno H, Koretsune Y, Kusuoka H, Yasumura Y (2009) Successful catheter ablation to accessory atrioventricular pathway as cardiac resynchronization therapy in a patient with dilated cardiomyopathy. Europace 11:121–123PubMedCrossRefGoogle Scholar
  11. 11.
    Kwon BS, Bae EJ, Kim GB, Noh CI, Choi JY, Yun YS (2009) Septal dyskinesia and global left ventricular dysfunction in pediatric Wolff-Parkinson-White syndrome with septal accessory pathway. J Cardiovasc Electrophysiol 21:290–295PubMedCrossRefGoogle Scholar
  12. 12.
    Yamanaka S, Shirayama T, Inoue K, Kawata K, Yagi T, Azuma A, Inoue D, Nakagawa M (1998) Improved cardiac function after catheter ablation in a patient with type B Wolff-Parkinson-White syndrome with an old myocardial infarction. Jpn Circ J 62:860–862PubMedCrossRefGoogle Scholar
  13. 13.
    Park HE, Chang SA, Kim JH, Oh IY, Choi EK, Oh S (2012) Left ventricular dyssynchrony in pre-excitation syndrome: effect of accessory pathway location and reversibility after ablation therapy. Heart Vessels. doi: 10.1007/s00380-012-0233-x Google Scholar
  14. 14.
    Freudenberger RS, Wilson AC, Lawrence-Nelson J, Hare JM, Kostis JB (2005) Permanent pacing is a risk factor for the development of heart failure. Am J Cardiol 95:671–674PubMedCrossRefGoogle Scholar
  15. 15.
    De Boeck BW, Teske AJ, Leenders GE, Mohamed Hoesein FA, Loh P, van Driel VJ, Doevendans PA, Prinzen FW, Cramer MJ (2010) Detection and quantification by deformation imaging of the functional impact of septal compared to free wall preexcitation in the Wolff-Parkinson-White syndrome. Am J Cardiol 106:539–546 e2Google Scholar

Copyright information

© Springer Japan 2013

Authors and Affiliations

  • Hideo Fukunaga
    • 1
  • Katsumi Akimoto
    • 1
  • Takeshi Furukawa
    • 1
  • Ken Takahashi
    • 1
  • Masahiko Kishiro
    • 1
  • Toshiaki Shimizu
    • 1
  • Hiroshi Kamiyama
    • 2
  • Naokata Sumitomo
    • 2
    Email author
  1. 1.Department of PediatricsJuntendo University Faculty of MedicineTokyoJapan
  2. 2.Department of Pediatrics and Child HealthNihon University School of MedicineTokyoJapan

Personalised recommendations