The impact of left ventricular deformation and dyssynchrony on improvement of left ventricular ejection fraction following radiofrequency catheter ablation in Wolff-Parkinson-White syndrome: A comprehensive study by speckle tracking echocardiography.

Abstract

The purpose of this study was to evaluate left ventricular (LV) deformation and LV dyssynchrony in patients with Wolff-Parkinson-White (WPW) syndrome and to identify the factors that affect the efficacy of radiofrequency catheter ablation (RFCA). Thirty patients (26 men, mean age 40±12years) with WPW syndrome were prospectively recruited for this study. They underwent 2-dimensional transthoracic echocardiography with speckle tracking analysis before RFCA and again within 48hours after RFCA. Control group consisted of 15 age and sex-matched healthy volunteers. The patients had significantly lower LV ejection fraction (LVEF), global longitudinal strain (Sl ), and global circumferential strain (Sc ) compared with healthy controls (64%±8% vs 68%±5%, P=.049; -17.6%±3.2% vs -19.9%±3.3%, P=.037, -15.2%±2.5% vs -19.4%±2.5%, P<.0001, respectively). Patients had a significantly higher dyssynchrony index relative to healthy controls (58.4±49.0ms vs 36.4±31.1ms, P=.031). After RFCA, there was a significant increase in LVEF and global Sc (68%±8% vs 64%±8%, P=.005; -17.3%±2.0% vs -15.2%±2.5%, P<.0001, respectively), along with a significant decrease in the dyssynchrony index (36.9±36.3ms vs 58.4±ms, P<.001) relative to the baseline values. Logistic regression revealed that the baseline dyssynchrony index was a predictor of LVEF improvement after RFCA (odds ratio: 1.060, P=.038). In WPW syndrome, impaired LV circumferential deformation can be restored by RFCA with concomitant improvement in LV dyssynchrony and LVEF.