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Association between severity of cardiac dysfunction caused by ventricular pre‐excitation‐led dyssynchrony and cardiac function recovery after ablation in children
Author(s) -
Zhang Yi,
Li XiaoMei,
Jiang He,
Cui Jian,
Ge HaiYan,
Liu HaiJu,
Li MeiTing
Publication year - 2020
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.14521
Subject(s) - ejection fraction , medicine , cardiology , hazard ratio , cardiac function curve , confidence interval , diastole , heart failure , blood pressure
Objective To investigate the association between the severity of cardiac dysfunction caused by ventricular pre‐excitation‐led dyssynchrony and cardiac function recovery time after catheter ablation and identify predictors of cardiac function recovery after ablation. Methods and Results A total of 49 children underwent successful ablation (median 2.92 years). This study included 23 patients with mild cardiac dysfunction (left ventricular ejection fraction [LVEF]: 45% ≤ LVEF ≤ 55%), 15 with moderate (30% ≤ LVEF < 45%), and 11 with severe (LVEF <30%). The time for mean LVEF reaching 55% was 0.75, 3, and more than 12 months, respectively. The mean LVEF of children with severe cardiac dysfunction aged ≤6 years normalized within 12 months of follow‐up (63.00% ± 1.41%). Mean LVEF of those aged more than 6 years did not normalize at 12 months of follow‐up (38.67% ± 10.97%). LVEF recovery time was significantly different between these two age groups (median 11 months vs >12 months, χ 2 = 4.55; P = .04). Cox regression analysis showed that preablation smaller left ventricular diastolic diameter (LVDd) Z score and higher LVEF were predictors of cardiac dysfunction recovery time (hazard ratio [HR] = 0.91, 95% confidence interval [CI] = 0.82‐0.99, P = .04; HR = 1.09, 95% CI = 1.03‐1.15, P = .01). Conclusion Patients with higher LVDd Z scores and lower LVEF tend to have slower improvement in cardiac function after ablation. Patients with LVEF less than 30% and aged more than 6 years need more than 12 months to fully recover, and some might not even completely recover. Early catheter ablation is suggested once ventricular pre‐excitation‐led cardiac dysfunction is suspected.