A case of Type-C Wolff-Parkinson-White syndrome with severe left ventricular dysfunction: Efficacy of catheter ablation

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• 作者：Miho Haraguchi ; MD ; Hidekazu Kondo ; MD ; PhD ; ^{hkondo@oita-u.ac.jp} ; Yumi Ishii ; MD ; Mami Kobukata ; MD ; Takaaki Imamura ; MD ; Toyokazu Otsubo ; MD ; Reika Ayabe ; MD ; Shotaro Saito ; MD ; PhD ; Yasuko Nagano ; MD ; PhD ; Hidefumi Akioka ; MD ; Tetsuji Shinohara ; MD ; PhD ; Yasushi Teshima ; MD ; PhD ; Kunio Yufu ; MD ; PhD ; Mikiko Nakagawa ; MD ; PhD ; Naohiko Takahashi ; MD ; PhD
• 关键词：Wolff&ndash ; Parkinson&ndash ; White syndrome ; Severe left ventricular dysfunction ; Radiofrequency catheter ablation ; Left ventricular dyssynchrony
• 刊名：Journal of Cardiology Cases
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：15
• 期：1
• 页码：32-35
• 全文大小：1942 K
• 卷排序：15

文摘

The present case report describes a 59-year-old female with manifest Wolff–Parkinson–White syndrome and severe left ventricular (LV) dysfunction, however, there was no indication of heart palpitations. The polarity of delta is consistent with the features of the right anteroseptal accessory pathways (APs). The echocardiography showed a remarkable dyssynchrony of the LV wall motion. To circumvent the cardiac dysfunctions, radiofrequency catheter ablation (RFCA) was successfully performed to disconnect the AP. Thereafter, the dyssynchrony disappeared, and the clinical reports observed 6 months following RFCA showed that the LV ejection fraction had been improved from 13% up to 48%, in addition to the improvement in other parameters. The RFCA prevented her from receiving a cardiac resynchronization therapy defibrillator as well as a heart transplantation.<Learning Objective: There is a concern about the possibility that some patients with Wolff-Parkinson-White (WPW) syndrome and heart failure may be diagnosed with dilated cardiomyopathy (DCM). Because catheter ablation of the accessory pathway may improve the left ventricular (LV) dysfunction, one should exclude the accessory pathway conduction-induced LV dyssynchrony and LV dysfunction before diagnosing DCM. Even in absence of palpitations, catheter ablation may be effective in patients with manifest WPW syndrome to prevent the progression of LV dysfunction.>