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European Journal of Pediatrics

, Volume 172, Issue 11, pp 1491–1500 | Cite as

Dyssynchronous ventricular contraction in Wolff–Parkinson–White syndrome: a risk factor for the development of dilated cardiomyopathy

  • Chen-Cheng Dai
  • Bao-Jing Guo
  • Wen-Xiu Li
  • Yan-Yan Xiao
  • Mei Jin
  • Lin Han
  • Jing-Ping Sun
  • Cheuk-Man Yu
  • Jian-Zeng DongEmail author
Original Article

Abstract

Emerging evidence suggests that significant left ventricular dysfunction may arise in right-sided septal or paraseptal accessory pathways (APs) with Wolff–Parkinson–White syndrome, even in the absence of recurrent or incessant tachycardia. During 1 year and 9 months, we identified four consecutive female children with median age of 8 years diagnosed as having dilated cardiomyopathy (DCM) combined with overt right-sided APs several years ago. Incessant or recurrent tachycardia as the cause of DCM could be excluded. Anti-heart failure chemotherapy did not produce satisfactory effects. The patients underwent radiofrequency ablations (RFCAs). This report describes the clinical and echocardiographic characteristics of the cases before and after the ablation. Dyssynchronous ventricular contraction was observed in all patients. The locations of the APs were the right-sided anteroseptum and the free wall (n = 2 each). All patients received successful RFCAs. Their physical activities and growth improved greatly, and the echocardiographic data demonstrated that their left ventricular (LV) contraction recovered to synchrony shortly after the ablation and that their LV function recovered to normal gradually during the follow-up. Conclusions: A causal relationship between overt ventricular preexcitation and the development of DCM is supported by the complete recovery of LV function and reversed LV remodeling after the loss of ventricular preexcitation. Preexcitation-related dyssynchrony was probably the crucial mechanism. Not only right-sided septal or paraseptal but also free wall overt APs may induce LV dysfunction and even DCM. AP-induced DCM is an indication for ablation with a good prognosis.

Keywords

Wolff–Parkinson–White (WPW) syndrome Accessory pathway (AP) Dilated cardiomyopathy (DCM) Speckle tracking echocardiography Segmental dyskinesia 

Notes

Acknowledgments

Dr. Chen-Cheng Dai is financially supported by a Science Foundation from Dean of Capital Medical University affiliated Beijing Anzhen Hospital (project no. 2013Z09).

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Chen-Cheng Dai
    • 1
  • Bao-Jing Guo
    • 1
  • Wen-Xiu Li
    • 1
  • Yan-Yan Xiao
    • 1
  • Mei Jin
    • 1
  • Lin Han
    • 1
  • Jing-Ping Sun
    • 2
  • Cheuk-Man Yu
    • 2
  • Jian-Zeng Dong
    • 3
    Email author
  1. 1.Department of Pediatric CardiologyCapital Medical University, Beijing Anzhen HospitalBeijingChina
  2. 2.Department of CardiologyPrince of Wales Hospital, The Chinese University of Hong KongHong KongChina
  3. 3.Department of CardiologyCapital Medical University, Beijing Anzhen HospitalBeijingChina

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