Successful right anteroseptal manifest accessory pathway cryoablation in a six-month infant with dyssynchrony-induced dilated cardiomyopathy

Ventricular preexcitation via an accessory pathway (AP) results in an asynchronous spread of ventricular depolarization that may lead to an abnormal regional wall motion and systolic dysfunction in patients with Wolff–Parkinson–White (WPW) syndrome, even without documented supraventricular tachycardia (1-3). It is known that adults and children with preexcitation-associated cardiomyopathy can completely recover following resynchronization therapy (3-5). However, in infants, a very small number of patients have been treated with resynchronization via catheter ablation and only one case with less than 6 months of radiofrequency ablation was found in the current literature (5, 6). We present our report of one of the youngest patients in the literature, who showed rapid and complete recovery of severe ventricular dyssynchrony and myocardial dysfunction after cryoablation of the right-sided manifest AP. Our case emphasizes that cryoablation can be preferred as a safe method for AP ablation in infants as well.