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

PurposeThe 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). MethodsThirty patients (26 men, mean age 4012years) 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. ResultsThe patients had significantly lower LV ejection fraction (LVEF), global longitudinal strain (S-l), and global circumferential strain (S-c) 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 S-c (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). ConclusionIn WPW syndrome, impaired LV circumferential deformation can be restored by RFCA with concomitant improvement in LV dyssynchrony and LVEF.