Document Detail

Dilated cardiomyopathy in children with ventricular preexcitation: the location of the accessory pathway is predictive of this association.
MedLine Citation:
PMID:  19879594     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Ventricular preexcitation may be associated with dilated cardiomyopathy, even in the absence of recurrent and incessant tachycardia. METHODS: This report describes the clinical and electrophysiologic characteristics of 10 consecutive children (6 males), with median age of 8 years (range, 1-17 years), who presented with dilated cardiomyopathy and overt ventricular preexcitation on the 12-lead electrocardiogram. Incessant tachycardia as the cause of dilated cardiomyopathy could be excluded. Coronary angiography, right ventricular endomyocardial biopsy (4/10 patients), and metabolic and microbiologic screening were nondiagnostic. RESULTS: The electrocardiograms suggested right-sided pathways in all patients. A right-sided accessory pathway was demonstrated in 8 patients during invasive electrophysiologic study (superoparaseptal, n = 5; septal, n = 2; fasciculoventricular, n = 1). All pathways were successfully ablated (radiofrequency ablation in 7, cryoablation in 1). Two patients had spontaneous loss of ventricular preexcitation during follow-up. Left ventricular (LV) function completely recovered after a loss of preexcitation in all patients. CONCLUSIONS: Right-sided accessory pathways with overt ventricular preexcitation and LV dyssynchrony may cause dilated cardiomyopathy. An association between such pathways and dilated cardiomyopathy is suggested by the rapid normalization of ventricular function and reverse LV remodeling after a loss of ventricular preexcitation.
Floris E A Udink ten Cate; Markus A Kruessell; Kerstin Wagner; Uwe Trieschmann; Mathias Emmel; Konrad Brockmeier; Narayanswami Sreeram
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-10-30
Journal Detail:
Title:  Journal of electrocardiology     Volume:  43     ISSN:  1532-8430     ISO Abbreviation:  J Electrocardiol     Publication Date:    2010 Mar-Apr
Date Detail:
Created Date:  2010-02-17     Completed Date:  2010-05-18     Revised Date:  2010-05-27    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  146-54     Citation Subset:  IM    
Copyright Information:
2010 Elsevier Inc. All rights reserved.
Department of Pediatric Cardiology, Heart Center, University Hospital of Cologne, Cologne, Germany.
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MeSH Terms
Cardiomyopathy, Dilated / complications*,  diagnosis*
Child, Preschool
Electrocardiography / methods*
Heart Conduction System / abnormalities*
Reproducibility of Results
Sensitivity and Specificity
Ventricular Premature Complexes / complications*,  diagnosis*
Young Adult

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