Amiodarone and catheter ablation as cardiac resynchronization therapy for children with dilated cardiomyopathy and wolff-Parkinson-white syndrome.

Abstract

Preexcitation by accessory pathways (APs) is known to cause dyssynchrony of the ventricle, related to ventricular dysfunction. Correction of ventricular dyssynchrony can improve heart failure in cases of dilated cardiomyopathy (DCMP) with preexcitation. Here, we report the first case of a child with DCMP and Wolff-Parkinson-White (WPW) syndrome treated with amiodarone and radiofrequency catheter ablation (RFCA) in Korea. A 7-year-old boy, who suffered from DCMP and WPW syndrome, showed improved left ventricular function and clinical functional class after treatment with amiodarone to eliminate preexcitation. QRS duration and left ventricular ejection fraction (LVEF) were inversely correlated with amiodarone dosage. After confirming the reduction of preexcitation effects in DCMP, successful RFCA of the right anterior AP resulted in LVEF improvement, along with the disappearance of preexcitation. Our findings suggest that ventricular dyssynchrony, caused by preexcitation in DCMP with WPW syndrome, can worsen ventricular function and amiodarone, as well as RFCA, which should be considered as a treatment option, even in young children.

• Authors: Sung Hoon Kim, Soo In Jeong, June Huh, I-Seok Kang, Heung Jae Lee
• Journal: Korean circulation journal (Korean Circ J) Vol. 43 Issue 1 Pg. 57-61 (Jan 2013) ISSN: 1738-5520 [Print] Korea (South)
• PMID: 23407697 (Publication Type: Journal Article)