{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:01:19Z","timestamp":1756310479284,"version":"3.41.2"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T00:00:00Z","timestamp":1725235200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Conduction abnormalities are frequently encountered in patients with Ebstein anomaly. The following case describes the safe use of flecainide in an infant with accessory-pathway mediated left ventricular dysfunction in the setting of Ebstein anomaly.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case Summary<\/jats:title>\n                  <jats:p>An infant with an antenatal diagnosis of Ebstein anomaly developed progressive left ventricular dilatation and dysfunction over the first 2 months of life. ECG demonstrated persistent Wolff-Parkinson-White pattern with delta-wave polarity suggesting a right-sided septal accessory pathway. In the absence of SVT, accessory-pathway mediated dyssynchrony was suspected as the cause for left ventricular dilatation and dysfunction. He was commenced on flecainide which successfully blocked antegrade conduction via the accessory pathway resulting in a reduction in left ventricular volume and improvement in left ventricular systolic function. He remains asymptomatic at 12 months of age.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>There is a known association between Ebstein anomaly and Wolff-Parkinson-White pattern. Right-sided septal accessory pathways can cause cardiomyopathy secondary to dyssynchronous left ventricular contraction. In patients who are unsuitable for accessory pathway ablation, flecainide can be used to block antegrade conduction via the accessory pathway resulting in improved left ventricular function, which was successful on this occasion.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytae442","type":"journal-article","created":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T19:00:52Z","timestamp":1725303652000},"source":"Crossref","is-referenced-by-count":1,"title":["Pharmacological resynchronisation with flecainide in an infant with Ebstein anomaly and Wolff-Parkinson-White pattern: a case report"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5947-1208","authenticated-orcid":false,"given":"Gajon","family":"Uthayakumaran","sequence":"first","affiliation":[{"name":"The Heart Centre for Children, The Children\u2019s Hospital at Westmead , Corner Hawkesbury Road and Hainsworth St, Westmead, NSW 2145 , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1452-2964","authenticated-orcid":false,"given":"Hiroko","family":"Asakai","sequence":"additional","affiliation":[{"name":"The Heart Centre for Children, The Children\u2019s Hospital at Westmead , Corner Hawkesbury Road and Hainsworth St, Westmead, NSW 2145 , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7537-2990","authenticated-orcid":false,"given":"Ganesh","family":"Gnanappa","sequence":"additional","affiliation":[{"name":"The Heart Centre for Children, The Children\u2019s Hospital at Westmead , Corner Hawkesbury Road and Hainsworth St, Westmead, NSW 2145 , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,9,2]]},"reference":[{"key":"2024091010430028400_ytae442-B1","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1016\/j.jacep.2021.05.008","article-title":"Ebstein\u2019s anomaly review of arrhythmia types and morphogenesis of the anomaly","volume":"7","author":"He","year":"2021","journal-title":"JACC Clin Electrophysiol"},{"key":"2024091010430028400_ytae442-B2","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1161\/CIRCULATIONAHA.106.619338","article-title":"Ebstein\u2019s anomaly","volume":"115","author":"Jost","year":"2007","journal-title":"Circulation"},{"key":"2024091010430028400_ytae442-B3","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1055\/s-2000-6897","article-title":"Ebstein\u2019s anomaly in adults arrhythmias: diagnosis and therapeutic approach","volume":"48","author":"Hebe","year":"2000","journal-title":"Thorac Cardiov Surg"},{"key":"2024091010430028400_ytae442-B4","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/1058-9813(93)90042-X","article-title":"Embryology and pathologic features of Ebstein\u2019s anomaly","volume":"2","author":"Edwards","year":"1994","journal-title":"Prog Pediatr Cardiol"},{"key":"2024091010430028400_ytae442-B5","first-page":"181","article-title":"Adverse effects of Wolff\u2013Parkinson\u2013White syndrome with right septal or posteroseptal accessory pathways on cardiac function","volume":"10","author":"Tomaske","year":"2008","journal-title":"EP Eur"},{"key":"2024091010430028400_ytae442-B6","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1016\/j.hrthm.2008.05.022","article-title":"Severe left ventricular dysfunction in infants with ventricular preexcitation","volume":"5","author":"Cadrin-Tourigny","year":"2008","journal-title":"Hear Rhythm"},{"key":"2024091010430028400_ytae442-B7","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.jelectrocard.2009.09.007","article-title":"Dilated cardiomyopathy in children with ventricular preexcitation: the location of the accessory pathway is predictive of this association","volume":"43","author":"Udink ten Cate","year":"2010","journal-title":"J Electrocardiol"},{"key":"2024091010430028400_ytae442-B8","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1111\/j.1540-8167.2009.01612.x","article-title":"Septal dyskinesia and global left ventricular dysfunction in pediatric Wolff-Parkinson-White syndrome with septal accessory pathway","volume":"21","author":"Kwon","year":"2010","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2024091010430028400_ytae442-B9","first-page":"e251","article-title":"PACES\/HRS expert consensus statement on the use of catheter ablation in children and patients with congenital heart disease developed in partnership with the Pediatric and Congenital Electrophysiology Society (PACES) and the Heart Rhythm Society (HRS). 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