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

Purpose 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). Methods Thirty patients (26 men, mean age 40 ± 12 years) with WPW syndrome were prospectively recruited for this study. They underwent 2-dimensional transthoracic echocardiography with speckle tracking analysis before RFCA and again within 48 hours after RFCA. Control group consisted of 15 age and sex-matched healthy volunteers. Results 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 ± 49.0 ms vs 36.4 ± 31.1 ms, 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 ± 36.3 ms 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). Conclusion In WPW syndrome, impaired LV circumferential deformation can be restored by RFCA with concomitant improvement in LV dyssynchrony and LVEF.