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Hazards of ventricular pre-excitation to left ventricular systolic function and ventricular wall motion in children: analysis of 25 cases

Published online by Cambridge University Press:  15 February 2019

Baojing Guo ,
Chencheng Dai ,
Qiangqiang Li ,
Wenxiu Li  and
Ling Han Open the ORCID record for Ling Han [Opens in a new window]
Baojing Guo
Affiliation:
Department of Pediatric Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing100029, China
Chencheng Dai
Affiliation:
Department of Pediatric Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing100029, China
Qiangqiang Li
Affiliation:
Department of Pediatric Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing100029, China
Wenxiu Li
Affiliation:
Department of Pediatric Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing100029, China
Ling Han*
Affiliation:
Department of Pediatric Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing100029, China
*
Author for correspondence: Ling Han, MD, Department of Pediatric Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China. Tel: +86-10-6445-6874; Fax: +86-10-6445-6874; E-mail: hanlinaz2017@sina.com
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Abstract

Aim

The aim was to attach importance to the hazards of ventricular pre-excitation on left ventricular systolic function and size.

Method

We analysed the clinical, electrophysiological, and echocardiographic characteristics of the 25 cases with abnormal ventricular wall motion, left ventricular systolic dysfunction, or dilation with co-existing right-sided overt accessary pathways before and after ablation or medication during March 2011 and June 2017. Moreover, we compared the therapy effect between patients with ventricular pre-excitation-induced dilated cardiomyopathy and idiopathic dilated cardiomyopathy without ventricular pre-excitation.

Result

Abnormal ventricular wall motion was demonstrated using M-mode echocardiography in 23 cases. The basal segments of the interventricular septum became thin and moved similarly to an aneurysm with typical bulging during end-systole, which was observed in 16 cases. Dilated cardiomyopathy was diagnosed in 14 cases. A total of 23 patients underwent successful ablations and received medications, and the other two patients received only oral medications because of young age. The prognosis of pre-excitation-induced dilated cardiomyopathy is better than idiopathic dilated cardiomyopathy. All the cases with abnormal ventricular wall motion demonstrated recovery of normal left ventricular ejection fraction and decreased left ventricular end-diastolic diameter through ablation.

Conclusion

Ventricular pre-excitation caused by right-sided accessory pathways may result in abnormal ventricular wall motion, left ventricular systolic dysfunction, dilation, and even dilated cardiomyopathy. In some cases with dilated cardiomyopathy, ventricular pre-excitation may not be the cause of disease but a harmful factor which hampered the recovering of left ventricular systolic function. These conditions are indications for ablation with good prognosis.

Keywords

Ventricular pre-excitationaccessory pathwaydyssynchronydilated cardiomyopathy

Information

Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 3 , March 2019 , pp. 380 - 388
Copyright
© Cambridge University Press 2019 

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Footnotes

Cite this article: Guo B, Dai C, Li Q, Li W, Han L. (2019) Hazards of ventricular pre-excitation to left ventricular systolic function and ventricular wall motion in children: analysis of 25 cases. Cardiology in the Young29: 380–388. doi: 10.1017/S1047951118002500

*

Baojing Guo and Chencheng Dai contribute equal to the article.

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