Transesophageal echo phase imaging for localizing accessory pathways during adenosine-induced preexcitation in patients with the Wolff-Parkinson-White syndrome

Kuecherer, Helmut F.; Kleber, Gaspar-da-Silva; Melichercik, Juraj; Schützendübel, Rudolph; Beyer, Thorsten; Brachmann, Johannes; Kübler, W.

doi:10.1016/s0002-9149(97)89136-9

Cited by 16 publications

(12 citation statements)

References 27 publications

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“…It has been reported that several echocardiographic approaches predict the accessory pathway location in WPW syndrome, including conventional M-mode imaging [10, 11, 12, 13, 14], digital two-dimensional imaging [15]and transesophageal two-dimensional phase analysis [16, 17]. Conventional M-mode echocardiography can analyze a rapidly moving structure because of its high temporal resolution afforded by the high sampling rate.…”

Section: Discussionmentioning

confidence: 99%

“…Using this method, the accessory pathway location is subjectively interpreted by visual estimation. Transesophageal two-dimensional phase analysis using a first harmonic Fourier algorithm can predict the accessory pathway location [16, 17]. In this procedure, the phase image of a single cross-sectional view can be obtained in and analyzed within several minutes and displays the mechanical contraction in a more objective format.…”

Section: Discussionmentioning

confidence: 99%

“…The accessory pathway location was diagnosed as an adjacent region in some WPW patients. To obtain a correct diagnosis, maximal preexcitation should be induced by pharmacological augmentation (i.e., adenosine) in WPW patients with a small δ wave [17]. It remains uncertain whether tissue Doppler is a useful approach in WPW patients with multiple pathways, because such patients were not enrolled in the present study.…”

Section: Discussionmentioning

confidence: 99%

“…A standard 12-lead ECG [3, 4, 5, 6]and body surface mapping [7, 8, 9]are used to determine the early electrical activation site. As echocardiographic approaches to this syndrome, conventional M-mode imaging [10, 11, 12, 13, 14], digital two-dimensional imaging [15]and transesophageal two-dimensional phase analysis [16, 17]have been reported. However, these methods have some technical restrictions in clinical use, and noninvasive pinpoint localization of the accessory pathways still seems to be difficult.…”

Section: Introductionmentioning

confidence: 99%

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Detection of the Earliest Ventricular Contraction Site in Patients with Wolff-Parkinson-White Syndrome Using Two-Dimensional Guided M-Mode Tissue Doppler Echocardiography

Nagai

Takata²,

Sakagami³

et al. 1999

Cardiology

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Objective: The purpose of this study was to examine the feasibility of M-mode tissue Doppler imaging for localizing the accessory pathway in patients with Wolff-Parkinson-White (WPW) syndrome. Methods: Two-dimensional guided tissue Doppler M-mode was recorded at the mitral and tricuspid annular levels in 13 WPW patients. Time intervals were measured from the onset of the δ wave or the R wave to the beginning of the ventricular systolic motion. The earliest contraction site was defined as the site demonstrating the shortest time interval, and compared with the earliest activated site determined by body surface mapping and the successful ablation site. Results: In 6 patients with a left-sided pathway, tissue Doppler localization was identical to the ablation site. In 3 with a left-sided pathway and 3 with a right-sided pathway, localization was judged as an adjacent region of the ablation site. In 1 patient with a right lateral pathway, the pathway location was misdiagnosed. The tissue Doppler diagnosis for the left-sided pathways correlated well with the ablation site, in contrast to the right-sided pathways (p = 0.05). Prediction of the accessory pathway localization by tissue Doppler M-mode was equivalent to localization based on body surface mapping. Conclusions: In WPW syndrome, tissue Doppler M-mode can detect the earliest contraction sites and seems helpful in localizing the left-sided accessory pathways, but is of limited use for right-sided pathways.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Detection of the Earliest Ventricular Contraction Site in Patients with Wolff-Parkinson-White Syndrome Using Two-Dimensional Guided M-Mode Tissue Doppler Echocardiography

Nagai

Takata²,

Sakagami³

et al. 1999

Cardiology

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“…Delta wave polarity or QRS polarity on a 12 lead ECG has been widely used to determine accessory pathway location. [1][2][3][4][5] Related to echocardiography, M-mode echocardiography, [6][7][8] phase analysis of echocardiographic images, 9,10) Doppler tissue imaging, 11,12) and Doppler myocardial imaging 13) have also been employed to detect the accessory pathway side. These methods have focused mainly on abnormal ventricular motion.…”

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confidence: 99%

Effect of Radiofrequency Catheter Ablation on Doppler Echocardiographic Parameters in Patients With Wolff-Parkinson-White Syndrome

et al. 2007

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SUMMARYThe aim of this study was to compare the conventional Doppler echocardiographic parameters before and after accessory pathway ablation in patients with Wolff-ParkinsonWhite (WPW) syndrome. Thirty patients (19 males, 11 females) aged 35.5 ± 14.4 years were enrolled in the study. All patients underwent successful radiofrequency catheter ablation (RFCA). Echocardiograhic examination was performed before and after RFCA. Aortic and pulmonary flows, diastolic early (E) and late (A) transmitral filling velocities, their velocity time integrals (VTI), mitral diastolic filling time (DFT), deceleration time (DT), isovolumic relaxation time (IVRT), aortic ejection time, and aortic VTI were assessed before and after RFCA. We found that the pulmonary valve opened earlier than the aortic valve when the accessory pathway was located on the right ventricular side (P = 0.02). Otherwise, if the accessory pathway was located on the left ventricular side, the aortic valve opened earlier (P < 0.01). Intervals between the onsets of aortic and pulmonary flows were shortened after RFCA (P = 0.01). We also observed prolongation of DFT (P < 0.001), increases in A velocity (P < 0.05) and its VTI (P < 0.01), as well as a decrease in the E/A ratio (P < 0.01) and shortening of aortic ejection time (P = 0.01) with restoration of AV conduction. We conclude that Doppler echocardiographic examination can provide clues about accessory pathway location and RFCA causes some significant changes in Doppler echocardiographic time intervals. These changes confirm that cardiac synchrony is restored after RFCA. (Int Heart J 2007; 48: 165-175)

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Utility of Intracardiac Echocardiography in Cardiac Electrophysiology

Packer¹

2007

Catheter Ablation of Cardiac Arrhythmias

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Transesophageal echo phase imaging for localizing accessory pathways during adenosine-induced preexcitation in patients with the Wolff-Parkinson-White syndrome

Cited by 16 publications

References 27 publications

Detection of the Earliest Ventricular Contraction Site in Patients with Wolff-Parkinson-White Syndrome Using Two-Dimensional Guided M-Mode Tissue Doppler Echocardiography

Detection of the Earliest Ventricular Contraction Site in Patients with Wolff-Parkinson-White Syndrome Using Two-Dimensional Guided M-Mode Tissue Doppler Echocardiography

Effect of Radiofrequency Catheter Ablation on Doppler Echocardiographic Parameters in Patients With Wolff-Parkinson-White Syndrome

Utility of Intracardiac Echocardiography in Cardiac Electrophysiology

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