Document Detail

Septal dyskinesia and global left ventricular dysfunction in pediatric Wolff-Parkinson-White syndrome with septal accessory pathway.
MedLine Citation:
PMID:  19804548     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Echocardiographic studies have shown that some patients with Wolff-Parkinson-White (WPW) syndrome have myocardial dyskinesia in the segments precociously activated by an accessory pathway (AP). The aim of the present study was to determine the extent to which the AP contributes to global left ventricular (LV) dysfunction. METHODS: Electrophysiological and echocardiographic data from 62 children with WPW (age at diagnosis = 5.9 +/- 4.2 years) were retrospectively analyzed. RESULTS: The left ventricular ejection fraction (LVEF) of patients with septal APs (53 +/- 11%) was significantly lower than that of patients with right (62 +/- 5%) or left (61 +/- 4%) APs (P = 0.001). Compared to patients with normal septal motion (n = 56), patients with septal dyskinesia (n = 6) had a reduced LVEF (61 +/- 4% and 42 +/- 5%, respectively) and an increased LV end diastolic dimension (P < 0.001 for both comparisons). Multivariate analysis identified septal dyskinesia as the only significant risk factor for reduced LVEF. All 6 patients with septal dyskinesia had right septal APs, and a preexcited QRS duration that was longer than that of patients with normal septal motion (140 +/- 18 ms and 113 +/- 32 ms, respectively; P = 0.045). After RFA there were improvements in both intraventricular dyssynchrony (septal-to-posterior wall motion delay, from 154 +/- 91 ms to 33 +/- 17 ms) and interventricular septal thinning (from 3.0 +/- 0.5 mm to 5.3 +/- 2.6 mm), and a significant increase in LVEF (from 42 +/- 5% to 67 +/- 8%; P = 0.001). CONCLUSION: The dyskinetic segment activated by a right septal AP in WPW syndrome may lead to ventricular dilation and dysfunction. RFA produced mechanical resynchronization, reverse remodeling, and improvements in LV function.
Bo Sang Kwon; Eun Jung Bae; Gi Beom Kim; Chung Il Noh; Jung Yun Choi; Yong Soo Yun
Related Documents :
7418158 - The complementary roles of m-mode echocardiography and scintigraphy in the evaluation o...
18710878 - Cardiac mitochondria in heart failure: decrease in respirasomes and oxidative phosphory...
17164018 - Which cardiac surgical patients can benefit from placement of a pulmonary artery catheter?
7305418 - Correction of isolated secundum atrial septal defect in infancy.
22385558 - Left atrial primary b cell lymphoma presenting with mitral regurgitation.
10807458 - Unprotected left main coronary artery stenting: immediate and medium-term outcomes of 1...
Publication Detail:
Type:  Journal Article     Date:  2009-10-05
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  21     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-05-21     Completed Date:  2010-09-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  290-5     Citation Subset:  IM    
Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Child, Preschool
Heart Conduction System / abnormalities*,  physiopathology*
Heart Septal Defects / physiopathology*
Heart Septum / physiopathology*
Infant, Newborn
Ventricular Dysfunction, Left / physiopathology*
Wolff-Parkinson-White Syndrome / physiopathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Chronic Augmentation of the Parasympathetic Tone to the Atrioventricular Node: A Nonthoracotomy Neur...
Next Document:  Magnetic Resonance Imaging-Confirmed Ablative Debulking of the Left Atrial Posterior Wall and Septum...