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BioMed Research International
Volume 2013 (2013), Article ID 158621, 7 pages
Research Article

Ventricular Dyssynchrony and Function Improve following Catheter Ablation of Nonseptal Accessory Pathways in Children

1Department of Pediatric Cardiology, Sainte-Justine Hospital, Université de Montréal, Montreal, QC, Canada H3T 1C5
2Department of Cardiology, Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada H1T 1C8

Received 8 April 2013; Accepted 9 June 2013

Academic Editor: Stamatios Lerakis

Copyright © 2013 Sylvia Abadir et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Introduction. Paradoxical or hypokinetic interventricular septal motion has been described in patients with septal or paraseptal accessory pathways. Data regarding nonseptal pathways is limited. Methods and Results. We quantified left ventricular dyssynchrony and function in 16 consecutive children, years, weighing  kg, prior to and following catheter ablation of bidirectional septal ( ) and nonseptal ( ) accessory pathways. Following ablation, the left ventricular ejection fraction increased by % ( ) from a baseline value of . By tissue Doppler imaging, the interval between QRS onset and peak systolic velocity (Ts) decreased from a median of 33.0 ms to 18.0 ms ( ). The left ventricular ejection fraction increased to a greater extent following catheter ablation of nonseptal ( , ) versus septal ( , ) pathways. The four patients with an ejection fraction <50%, two of whom had left lateral pathways, improved to >50% after ablation. Similarly, the improvement in dyssynchrony was more marked in patients with nonseptal versus septal pathways (difference between septal and lateral wall motion delay before and after ablation  ms ( ) versus  ms ( )). Conclusion. Left ventricular systolic function and dyssynchrony improve after ablation of antegrade-conducting accessory pathways in children, with more pronounced changes noted for nonseptal pathways.