Left ventricular dysfunction in a child with asymptomatic pre-excitation: Cure with catheter ablation

Area of Science:

• Pediatric Cardiology
• Electrophysiology
• Cardiomyopathy Research

Background:

• Wolff-Parkinson-White syndrome (WPW) is associated with left ventricular dysfunction, often secondary to sustained tachycardia in pediatric populations.
• However, ventricular dysfunction directly from pre-excitation's abnormal activation patterns is less commonly reported.
• Early recognition is crucial as intervention can reverse cardiac dysfunction.

Observation:

• A 2.5-year-old patient presented with tachycardia-free WPW syndrome.
• The patient exhibited a right free wall accessory pathway and depressed cardiac function.
• Despite being tachycardia-free, the patient had impaired left ventricular function.

Findings:

• Successful catheter cryoablation was performed to eliminate the accessory pathway.
• Post-ablation, the patient demonstrated complete restoration of left ventricular function.
• This case highlights recovery even without sustained tachycardia.

Implications:

• Catheter ablation of accessory pathways is an effective treatment for WPW-related cardiac dysfunction in children.
• Prompt diagnosis and intervention can lead to rapid and complete recovery of ventricular function.
• This approach offers a potentially life-saving option for pediatric patients with WPW and cardiac compromise.