A. Tuchnitz et al., Noninvasive localization of accessory pathways in patients with Wolff-Parkinson-White syndrome with the use of myocardial Doppler imaging, J AM S ECHO, 12(1), 1999, pp. 32-40
Citations number
30
Categorie Soggetti
Cardiovascular & Respiratory Systems
Journal title
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY
This study sought to examine the diagnostic accuracy of noninvasive predict
ion of accessory pathway localization in patients with manifest Wolff-Parki
nson-White syndrome with the use of myocardial Doppler imaging as a new non
invasive mapping procedure. Myocardial Doppler imaging measures myocardial
velocities and therefore can determine the site of earliest ventricular act
ivation in patients with accessory bypass tracts. Twenty-five patients with
manifest preexcitation were studied with the use of pulsed wave and M-mode
myocardial Doppler imaging for the evaluation of the shortest electromecha
nical time interval in 9 basal myocardial segments. The new diagnostic test
was compared with 3 electrocardiographic algorithms. An invasive mapping p
rocedure served as reference standard. Abnormally short electromechanical t
ime intervals were found in preexcited segments (27 +/- 12 ms vs 64 +/- 27
ms). Myocardial Doppler imaging correctly localized 84% of the accessory pa
thways and electrocardiographic algorithms only 48% to 60% of cases. Noninv
asive prediction of accessory pathway localization by myocardial Doppler im
aging is accurate and proved to be superior to prediction based on electroc
ardiographic algorithms.