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Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
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Arrhythmias are irregular heart rhythms occurring when the heart's electrical impulses become abnormal. These disturbances can lead to various symptoms, depending on their severity and the underlying cause. Some common factors contributing to arrhythmias include hypoxia, ischemia, electrolyte imbalances, excessive catecholamine exposure, drug toxicity, and muscle overstretching. Arrhythmias can be classified into two main types based on the rate and site of origin of abnormal heart rhythms.
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A Model of Long-Term Ventricular Fibrillation in Isolated Rat Hearts
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Risk Factors Associated With Ventricular Dysfunction in Wolff-Parkinson-White Syndrome.

Hiroko Asakai1, Sharmila Udupa2, Christine Chiu-Man3

  • 1Heart Centre for Children, Children's Hospital at Westmead, Westmead, New South Wales, Australia.

CJC Pediatric and Congenital Heart Disease
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Summary

Ventricular dysfunction occurs in 4.5% of pediatric Wolff-Parkinson-White (WPW) syndrome cases, particularly with right-sided accessory pathways. Early assessment and ablation are recommended for these patients.

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Area of Science:

  • Pediatric Cardiology
  • Electrophysiology
  • Cardiac Anatomy

Background:

  • Wolff-Parkinson-White (WPW) syndrome can present with ventricular dysfunction even without sustained tachyarrhythmias.
  • Understanding the prevalence and risk factors for ventricular dysfunction in pediatric WPW is crucial.

Purpose of the Study:

  • To determine the prevalence of ventricular dysfunction in children with WPW syndrome.
  • To identify risk factors associated with ventricular dysfunction in this population.

Main Methods:

  • Retrospective analysis of pediatric patients (<18 years) with WPW syndrome and normal cardiac anatomy.
  • Electrophysiology study and ablation data were reviewed over a 14-year period.
  • Ventricular dysfunction defined as ejection fraction <55%.

Main Results:

  • 14 out of 305 patients (4.5%) exhibited ventricular dysfunction.
  • Heart failure was the primary symptom in 28% of cases with dysfunction.
  • Right-sided accessory pathways, specifically right anteroseptal, anterior, and anterolateral locations, were more prevalent in patients with dysfunction.

Conclusions:

  • Ventricular dysfunction affects 4.5% of pediatric WPW syndrome patients, with specific right-sided pathway locations increasing risk.
  • These pathway locations confer a 4-fold increased risk of developing ventricular dysfunction.
  • Serial assessment of ventricular function and consideration of ablation are recommended for all pediatric WPW patients, especially those with identified risk factors.