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Open Access Dyssynchrony Induced by Ventricular Preexcitation: A Risk Factor for the Development of Dilated Cardiomyopathy

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This article is Open Access under the terms of the Creative Commons CC BY-NC licence.

Background: Significant left ventricular dysfunction may arise in right-sided accessory pathways with ventricular preexcitation in the absence of recurrent or incessant tachycardia. This has just been realized and not enough attention has been paid to it.

Methods: In the last 7 years, we identified 12 consecutive children with a diagnosis of ventricular preexcitation‐induced dilated cardiomyopathy. This report describes the clinical and echocardiographic characteristics of the patients before and after ablation.

Results: Dyssynchronous ventricular contraction was observed by M-mode echocardiography and two-dimensional strain analysis in all patients. The basal and middle segments of the interventricular septum became thin and moved similarly to an aneurysm, with typical bulging during the end of systole. The locations of the accessory pathways were the right-sided septum (n=5) and the free wall (n=7). Left ventricular synchrony was obtained shortly after ablation. The left ventricular function recovered to normal and the left ventricular end-diastolic diameter decreased gradually during follow-up.

Conclusions: A causal relationship between ventricular preexcitation and the development of dilated cardiomyopathy is supported by the complete recovery of left ventricular function and reversed left ventricular remodeling after the loss of ventricular preexcitation. Preexcitation-related dyssynchrony was thought to be the crucial mechanism. Ventricular preexcitation‐induced dilated cardiomyopathy is an indication for ablation with a good prognosis.

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Keywords: Wolff-Parkinson-White syndrome; accessory pathway; dilated cardiomyopathy; dyssynchrony; ventricular preexcitation

Document Type: Research Article

Affiliations: 1: Department of Pediatric Cardiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, 100029 Beijing, China 2: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, 100029 Beijing, China

Publication date: September 1, 2020

This article was made available online on June 10, 2020 as a Fast Track article with title: "Dyssynchrony Induced by Ventricular Preexcitation: A Risk Factor for the Development of Dilated Cardiomyopathy".

More about this publication?
  • Cardiovascular Innovations and Applications (CVIA) publishes focused articles and original clinical research that explore novel developments in cardiovascular disease, effective control and rehabilitation in cardiovascular disease, and promote cardiovascular innovations and applications for the betterment of public health globally. The journal publishes basic research that has clinical applicability in order to promote timely communication of the latest insights relating to coronary artery disease, heart failure, hypertension, cardiac arrhythmia, prevention of cardiovascular disease with a heavy emphasis on risk factor modification. Cardiovascular Innovations and Applications is the official journal of the Great Wall International Congress of Cardiology (GW-ICC). It aims to continue the work of the GW-ICC by providing a global scientific communication platform for cardiologists that bridges East and West.

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