LV dyssynchrony as assessed by phase analysis of gated SPECT myocardial perfusion imaging in patients with Wolff-Parkinson-White syndrome

Abstract

Purpose The purpose of this study was to evaluate left ventricular (LV) mechanical dyssynchrony in patients with Wolff-Parkinson-White (WPW) syndrome pre- and post-radiofrequency catheter ablation (RFA) using phase analysis of gated single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). Methods Forty-five WPW patients were enrolled and had gated SPECT MPI pre- and 2–3 days post-RFA. Electrophysiological study (EPS) was used to locate accessory pathways (APs) and categorize the patients according to the AP locations (septal, left and right free wall). Electrocardiography (ECG) was performed pre- and post-RFA to confirm successful elimination of the APs. Phase analysis of gated SPECT MPI was used to assess LV dyssynchrony pre- and post-RFA. Results Among the 45 patients, 3 had gating errors, and thus 42 had SPECT phase analysis. Twenty-two patients (52.4 %) had baseline LV dyssynchrony. Baseline LV dyssynchrony was more prominent in the patients with septal APs than in the patients with left or right APs (p<0.05). RFA improved LV synchrony in the entire cohort and in the patients with septal APs (p<0.01). Conclusion Phase analysis of gated SPECT MPI demonstrated that LV mechanical dyssynchrony can be present in patients with WPW syndrome. Septal APs result in the greatest degree of LV mechanical dyssynchrony and afford the most benefit after RFA. This study supports further investigation in the relationship between electrical and mechanical activation using EPS and phase analysis of gated SPECT MPI.

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

“…Currently, only a limited number of studies have investigated LV function relating to RFCA using both conventional echocardiography and STE in patients with WPW syndrome . A summary of these published clinical studies is represented in Table .…”

“…[11][12][13][14][15]21 Currently, only a limited number of studies have investigated LV function relating to RFCA using both conventional echocardiography and STE in patients with WPW syndrome. 11,13,15,21,34,35 A summary of these published clinical studies is represented in Table 5. Among these studies, the effects of RFCA on the left ventricular function were inconsistent and controversial.…”

The Effect of Accessory Pathway Location on Cardiac Function in Adult Patients with Wolff–Parkinson–White Syndrome

“…However, LVEF improved, and SPWMD decreased afterwards, indicating that WPW syndrome with right septal or posteroseptal accessory pathways may cause LV dyssynchrony and jeopardize global LV function. Chen et al [ 17 ] used single-photon emission computed tomography (SPECT) to identify LV dyssynchrony in 22 of a cohort of 42 patients with ventricular pre-excitation; most of those with dyssynchrony had accessory pathways in the right-sided septal wall. Hishida et al [ 18 ] reported that right and left free wall accessory pathways cause abnormal motion of the septal wall and left posterior wall, respectively.…”

Evaluation of the intraventricular dyssynchrony in patients with manifesting ventricular preexitation using three-dimensional echocardiography

“…практику радионуклидных и эхокардиографических методов диагностики стали появляться данные о повышении вероятности развития левожелудочковой дисфункции при манифестировании ДПП [5][6][7][8]. Так, продемонстрировано, что наличие манифестных правых септальных и задних парасептальных ДПП может привести к диссинхронии, которая становится причиной ухудшения глобальной систолической функции левого желудочка (ЛЖ) [9,10].…”