Fukunaga Hideo, Akimoto Katsumi, Furukawa Takeshi, Takahashi Ken, Kishiro Masahiko, Shimizu Toshiaki, Kamiyama Hiroshi, Sumitomo Naokata
Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan.
Heart Vessels. 2013 Nov;28(6):802-7. doi: 10.1007/s00380-013-0322-5. Epub 2013 Feb 13.
A 6-year-old boy was referred for an evaluation of intolerance to physical activity at his elementary school. The patient had no episodes of palpitations. He was diagnosed as Wolff-Parkinson-White syndrome with a right-sided accessory pathway (AP) and dilated cardiomyopathy (DCM). Ventricular dyskinesis was detected mostly in the ventricular septum. Because the asynchronous septal motion caused by pre-excitation through a right-sided AP might deteriorate his cardiac function, he underwent an AP ablation, after which the asynchronous ventricular wall motion disappeared and the wall thickness improved. We suggest that an AP ablation may be the treatment of first priority in patients who have DCM-like dyskinesis even without sustained tachyarrhythmias.
一名6岁男孩因在小学时被评估为不耐受体育活动而前来就诊。该患者没有心悸发作。他被诊断为伴有右侧旁路（AP）的预激综合征和扩张型心肌病（DCM）。心室运动障碍主要在室间隔被检测到。由于通过右侧AP预激引起的室间隔异步运动可能会使他的心脏功能恶化，他接受了AP消融术，术后异步心室壁运动消失且室壁厚度改善。我们建议，即使没有持续性快速心律失常，对于有类似DCM运动障碍的患者，AP消融术可能是首要治疗方法。
