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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
Reversible left ventricular dyssynchrony and dysfunction resulting from right ventricular pre-excitation
Qijun Shan1, Yu Jin, Kejiang Cao
1Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, PR China.
Summary
Accessory pathways can cause ventricular pre-excitation, leading to heart dysfunction in children. Catheter ablation successfully treated a young girl, restoring normal cardiac function and size.
Area of Science:
- Pediatric Cardiology
- Electrophysiology
- Cardiac Imaging
Background:
- Accessory atrioventricular pathways (APs) can cause ventricular pre-excitation.
- Pre-excitation may lead to cardiac dysfunction and remodeling.
Observation:
- A 7-year-old girl presented with right ventricular pre-excitation and depressed cardiac function.
- Echocardiography showed left ventricular (LV) dilatation, asynchronous wall motion, and reduced ejection fraction.
Findings:
- Electrophysiological study identified a para-Hisian AP.
- Successful catheter ablation of the AP resolved asynchronous ventricular wall motion.
- Cardiac size and function normalized within 3 months post-ablation.
Implications:
- Ventricular pre-excitation-induced asynchronous motion may cause LV dilation and dysfunction.
- Catheter ablation can reverse cardiac remodeling in pediatric patients with APs.
- Early diagnosis and treatment of APs are crucial for preventing adverse cardiac remodeling.
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