Evaluation of Dyssynchrony in Wolff-Parkinson-White Syndrome Patients Before and After Radiofrequency Ablation

Maryam  Moradian; Mohammad Rafie  Khorgami; Avisa  Tabib; Mohammad  Dalili; Fariba  Rashidighader; Shabnam  Boudagh; Mohammad  Mahdavi; Reza  Abbaszadeh; Yasaman  Khalili; Soheila Hoseinzadeh  Moghadam

doi:10.18502/jthc.v20i2.19704

Maryam Moradian Cardiovascular Research Center, Rajaie Cardiovascular Institute, Tehran, Iran.
Mohammad Rafie Khorgami Cardiovascular Research Center, Rajaie Cardiovascular Institute, Tehran, Iran.
Avisa Tabib Cardiogenetic Research Center, Rajaie Cardiovascular Institute, Tehran, Iran.
Mohammad Dalili Cardiovascular Research Center, Rajaie Cardiovascular Institute, Tehran, Iran.
Fariba Rashidighader Cardiovascular Research Center, Rajaie Cardiovascular Institute, Tehran, Iran.
Shabnam Boudagh Echocardiography Research Center, Rajaie Cardiovascular Institute, Tehran, Iran.
Mohammad Mahdavi Cardiovascular Research Center, Rajaie Cardiovascular Institute, Tehran, Iran.
Reza Abbaszadeh Cardiovascular Research Center, Rajaie Cardiovascular Institute, Tehran, Iran.
Yasaman Khalili Cardiovascular Research Center, Rajaie Cardiovascular Institute, Tehran, Iran.
Soheila Hoseinzadeh Moghadam Cardiovascular Research Center, Rajaie Cardiovascular Institute, Tehran, Iran.

DOI: https://doi.org/10.18502/jthc.v20i2.19704

Keywords: Radiofrequency Ablation; Wolff-Parkinson-White; Dyssynchrony; Accessory Pathway

Abstract

Objective: To evaluate the impact of radiofrequency ablation (RFA) on dyssynchrony in children with Wolff-Parkinson-White (WPW) syndrome.

Methods: This pre-post interventional study was conducted at Rajaie Cardiovascular Institute in Tehran, Iran, and included patients with WPW syndrome who had accessory pathways and were candidates for RFA. Demographic and baseline data, such as age and sex, were recorded. Patients underwent ECG studies and RFA of their accessory pathways. Twelve-lead ECG was performed before and one day after RFA. Standard echocardiographic views were obtained using a Vivid S60 system with appropriate transducers in 1D (M-mode) and 2D modes, along with Doppler evaluation. Intraventricular and interventricular dyssynchrony indices were assessed, and 2D strain analysis was performed. Data were analyzed using IBM SPSS Statistics for Windows, version 26.0.

Results: This study included 54 patients with WPW syndrome, 17 of whom had ventricular dyssynchrony. Ablation significantly affected QRS duration, PR interval, fractional shortening, left ventricular ejection fraction, and septal-to-posterior wall motion delay but did not significantly alter interventricular mechanical delay. The most common accessory pathways were left lateral, right posteroseptal, and left posteroseptal. The location of the accessory pathway was not significantly associated with the occurrence of dyssynchrony.

Conclusions: Based on the findings of this study, RF ablation eliminated dyssynchrony in all WPW patients and improved functional and strain parameters in this population. These improvements enhance cardiac function and reduce associated risks, particularly in pediatric patients.