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Cardiomiopatía dilatada mediada por vías accesorias en un bebé
Claire Bertail-Galoin1, Nabil Jbilou1, Victor Waldmann2
1Felix Guyon Hospital Center, CHU La Réunion, Competence Center for Complex Congenital Heart Disease - M3C, Saint-Denis, France.
Cardiology in the young
|August 26, 2025
Resumen
La miocardiopatía dilatada de un bebé de 10 meses de edad se resolvió mediante el tratamiento de la disincronia septal causada por la preexcitación de la vía accesoria. El tratamiento con flecaína normalizó la función ventricular izquierda eliminando la preexcitación.
Área de la Ciencia:
- Cardiología Pediátrica
- Electrofisiología
- Investigación de la cardiomiopatía
Sus antecedentes:
- La disincronia septal puede conducir a la miocardiopatía dilatada en los bebés.
- Las vías accesorias pueden causar anormalidades eléctricas cardíacas.
- Los síndromes de preexcitación pueden manifestarse sin taquicardia manifiesta.
Objetivo del estudio:
- Para describir un caso de miocardiopatía dilatada infantil relacionada con la preexcitación de la vía accesoria.
- Investigar el impacto de la preexcitación en la sincronía septal y la función ventricular.
- Evaluar la eficacia de la flecainida en el tratamiento de esta afección.
Principales métodos:
- Informe de caso de un bebé de 10 meses con miocardiopatía dilatada.
- Análisis del electrocardiograma (ECG) para identificar la preexcitación y la falta de sincronía.
- Evaluación de la función ventricular izquierda.
- Intervención terapéutica con flecainida.
Principales resultados:
- El bebé presentaba una miocardiopatía dilatada atribuida a la disincronia septal izquierda de una vía accesoria septal derecha.
- No se observó taquicardia atrioventricular recíproca.
- El tratamiento con flecaína eliminó con éxito la preexcitación antegrada en el ECG.
- La función ventricular izquierda se normalizó después del tratamiento.
Conclusiones:
- La preexcitación mediada por vías accesorias puede causar disincronia septal significativa y miocardiopatía dilatada en los lactantes.
- El diagnóstico precoz y la terapia antiarrítmica dirigida, como la flecainida, pueden revertir la disfunción cardíaca.
- Este caso destaca la importancia de considerar las anomalías electrofisiológicas en la miocardiopatía pediátrica.
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