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Association between severity of cardiac dysfunction caused by ventricular pre-excitation-led dyssynchrony and cardiac

Yi Zhang1,2, Xiao-Mei Li1,2, He Jiang1

  • 1Department of Pediatric Cardiology, Heart Center, First Hospital of Tsinghua University (Beijing Huaxin Hospital), Beijing, China.

Journal of Cardiovascular Electrophysiology
|April 29, 2020
PubMed

Insights

Children with severe cardiac dysfunction from ventricular pre-excitation show slower recovery after ablation. Younger children (<6 years) with severe dysfunction recover faster, highlighting the need for early intervention.

Area of Science:

  • Pediatric Cardiology
  • Electrophysiology
  • Cardiac Imaging

Background:

  • Ventricular pre-excitation can lead to cardiac dysfunction and dyssynchrony.
  • Catheter ablation is a treatment option for such conditions.
  • Understanding recovery patterns post-ablation is crucial for pediatric patients.

Purpose of the Study:

  • To examine the link between cardiac dysfunction severity and recovery time after ablation.
  • To identify predictors of cardiac function recovery in children post-ablation.

Main Methods:

  • Retrospective analysis of 49 children undergoing successful catheter ablation.
  • Categorization of cardiac dysfunction based on left ventricular ejection fraction (LVEF).
  • Statistical analysis including Cox regression to identify predictors of recovery.

Main Results:

  • Recovery time for LVEF varied significantly with initial dysfunction severity (mild: 0.75 months, moderate: 3 months, severe: >12 months).
  • Children aged ≤6 years with severe dysfunction showed LVEF normalization within 12 months, unlike older children.
  • Pre-ablation lower LVEF and smaller left ventricular diastolic diameter (LVDd) Z-score predicted slower recovery.

Conclusions:

  • Higher LVDd Z-scores and lower LVEF are associated with slower cardiac function improvement post-ablation.
  • Children with severe dysfunction (LVEF <30%) and >6 years old may require over 12 months for full recovery.
  • Early catheter ablation is recommended upon suspicion of ventricular pre-excitation-induced cardiac dysfunction.
Abstract

Keywords:
cardiac dysfunctioncatheter ablationchildrenprognosisventricular pre-excitation

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