Evaluation of Dyssynchrony in Wolff-Parkinson-White Syndrome Patients before and after Radiofrequency Ablation.

Highlights: Radiofrequency ablation significantly improved QRS duration, PR interval, fractional shortening, and LVEF in WPW patients.Intraventricular dyssynchrony (SPWMD) was markedly reduced after ablation, while interventricular delay (IVMD) showed no significant change.Two-dimensional strain analysis demonstrated significant improvement of dyssynchrony indices in all echocardiographic views after ablation.The location of accessory pathways was not significantly associated with dyssynchrony, yet ablation successfully eliminated dyssynchrony in all patients. 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.