Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Nov 14;15(1):32-35.
doi: 10.1016/j.jccase.2016.10.002. eCollection 2017 Jan.

A case of Type-C Wolff-Parkinson-White syndrome with severe left ventricular dysfunction: Efficacy of catheter ablation

Miho Haraguchi  1 , Hidekazu Kondo  1 , Yumi Ishii  1 , Mami Kobukata  1 , Takaaki Imamura  1 , Toyokazu Otsubo  1 , Reika Ayabe  1 , Shotaro Saito  1 , Yasuko Nagano  1 , Hidefumi Akioka  1 , Tetsuji Shinohara  1 , Yasushi Teshima  1 , Kunio Yufu  1 , Mikiko Nakagawa  1 , Naohiko Takahashi  1
Affiliations

A case of Type-C Wolff-Parkinson-White syndrome with severe left ventricular dysfunction: Efficacy of catheter ablation

Miho Haraguchi et al. J Cardiol Cases. .

Abstract

The present case report describes a 59-year-old female with manifest Wolff-Parkinson-White syndrome and severe left ventricular (LV) dysfunction, however, there was no indication of heart palpitations. The polarity of delta is consistent with the features of the right anteroseptal accessory pathways (APs). The echocardiography showed a remarkable dyssynchrony of the LV wall motion. To circumvent the cardiac dysfunctions, radiofrequency catheter ablation (RFCA) was successfully performed to disconnect the AP. Thereafter, the dyssynchrony disappeared, and the clinical reports observed 6 months following RFCA showed that the LV ejection fraction had been improved from 13% up to 48%, in addition to the improvement in other parameters. The RFCA prevented her from receiving a cardiac resynchronization therapy defibrillator as well as a heart transplantation. <Learning Objective: There is a concern about the possibility that some patients with Wolff-Parkinson-White (WPW) syndrome and heart failure may be diagnosed with dilated cardiomyopathy (DCM). Because catheter ablation of the accessory pathway may improve the left ventricular (LV) dysfunction, one should exclude the accessory pathway conduction-induced LV dyssynchrony and LV dysfunction before diagnosing DCM. Even in absence of palpitations, catheter ablation may be effective in patients with manifest WPW syndrome to prevent the progression of LV dysfunction.>.

Keywords: Left ventricular dyssynchrony; Radiofrequency catheter ablation; Severe left ventricular dysfunction; Wolff–Parkinson–White syndrome.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Cardiac magnetic resonance imaging. In contrast-enhanced cardiac magnetic resonance imaging, delayed enhancement was observed at the left ventricular posterior wall (red arrow).
Fig. 2
Fig. 2
Surface 12-lead electrocardiogram. (A) Before catheter ablation, the heart rate was 70 bpm; PR interval, 100 ms; and QRS duration, 145 ms. (B) Six months after catheter ablation, the heart rate was 54 bpm; PR interval, 150 ms; and QRS duration, 100 ms.
Fig. 3
Fig. 3
M-mode echocardiograms and radial (2-D) strain by speckle-tracking echocardiography in the short-axis view at the papillary muscle. The color cording of the strain curves refers to the respective left ventricular segments. (A) Before the catheter ablation. (B) After the catheter ablation.
Fig. 4
Fig. 4
Catheter mappings for radiofrequency catheter ablation (RFCA) and intracardiac electrocardiogram while delivering radiofrequency energy. (A) Atrial activation mapping during right ventricular pacing using 3D mapping. Bundle of His potential was recorded at the yellow points, and the earliest activation site was indicated by the red point. (B) The representative intracardiac electrocardiogram recording the block of antegrade conduction via the accessory pathway. The delta wave disappeared at 2.0 s after RFCA application.
See this image and copyright information in PMC

References

    1. Bristow M.R., Saxon L.A., Boehmer J., Krueger S., Kass D.A., De Marco T., Carson P., DiCarlo L., DeMets D., White B.G., DeVries D.W., Feldman A.M. Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med. 2004;350:2140–2150. - PubMed
    1. Cleland J.G., Daubert J.C., Erdmann E., Freemantle N., Gras D., Kappenberger L., Tavazzi L. The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med. 2005;352:1539–1549. - PubMed
    1. Tomaske M., Janousek J., Rázek V., Gebauer R.A., Tomek V., Hindricks G., Knirsch W., Bauersfeld U. Adverse effects of Wolff–Parkinson–White syndrome with right septal or posteroseptal accessory pathways on cardiac function. Europace. 2008;10:181–189. - PubMed
    1. Kwon B.S., Bae E.J., Kim G.B., Noh C.I., Choi J.Y., Yun Y.S. Septal dyskinesia and global left ventricular dysfunction inpediatric Wolff–Parkinson–White syndrome with septal accessory pathway. J Cardiovasc Electrophysiol. 2010;21:290–295. - PubMed
    1. Udink Ten Cate F.E., Wiesner N., Trieschmann U., Khalil M., Sreeram N. Dyssynchronous ventricular activation in asymptomatic Wolff–Parkinson–White syndrome: a risk factor for development of dilated cardiomyopathy. Indian Pacing Electrophysiol J. 2010;10:248–256. - PMC - PubMed

LinkOut - more resources