Assessment of Accessory Atrioventricular Pathways by Doppler Myocardial Imaging

Caso, Francesco; D’Andrea, Antonello; Musto, Carmine; Nardi, Stefano; Cavallaro, Ciro; Martiniello, Alfonso Roberto; Vecchione, F.; Mininni, N; Calabrò, Raffaele; Sutherland, F.E.S.C. George R.

doi:10.1046/j.1540-8175.2002.00373.x

Cited by 12 publications

(21 citation statements)

References 12 publications

(18 reference statements)

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“…Other methods that have been employed to detect the AP include M-mode echocardiography, phase analysis of 2-dimensional echocardiographic images, Doppler myocardial imaging, and TDI. [10][11][12][13][14][15][16][17] These methods have focused mainly on abnormal ventricular motion. Previous authors have, for example, analyzed the time-sequential changes in ventricular wall motion in WPW syndrome using TDI in their studies.…”

Section: Discussionmentioning

confidence: 99%

Localization of Accessory Pathway Using Tissue Doppler Echocardiography Prior Radiofrequency Ablation in Patients with Wolff-Parkinson-White Syndrome

Gül¹,

Eksik²,

Surgit³

et al. 2017

Turkiye Klinikleri J Cardiovasc Sci

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : We sought to examine the diagnostic accuracy of tissue Doppler imaging (TDI) for the localization of the accessory pathways (APs) in Wolff-Parkinson-White (WPW) syndrome. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : We prospectively studied 35 patients with evidence of pre-excitation on electrocardiography. Patients were categorized into three groups according to the site of the AP: left ventricular free wall; septal; and right ventricular free wall. The recordings obtained using TDI from the lateral mitral annulus, septal annulus, and lateral tricuspid annulus were respectively compared with the electrophysiological study (EPS) results for the location of the AP. Electromechanical interval (p-Sm) was defined as the time difference between the onset of the p wave and the onset of regional myocardial contraction (Sm) on echocardiography. R Re es su ul lt ts s: : In patients with left free access in EPS, electromechanical interval (pre-p-Sm) in the lateral mitral annulus was significantly shorter in the other two regions (septal annulus, and lateral tricuspid annulus) in TDI before treatment (p=0.0001). In patients with septal AP and right free AP detected at EPS, the pre-p-Sm interval was shorter, respectively, at the septal annulus and lateral tricuspid annulus, but was not statistically significant, due to the small numbers of patients in both regions. C Co on nc cl lu us si io on n: : The p-Sm interval in TDI before the ablation procedure, specifically in patients having a left free AP, was found to be short due to early stimulus. This was especially detected without using a free electrocardiogram (ECG) algorithm. The prediction of AP in TDI may play an important role in planning and performing the radiofrequency catheter ablation (RFCA).K Ke ey yw wo or rd ds s: : Wolff-Parkinson-White syndrome; echocardiography, Doppler Ö ÖZ ZE ET T A Am ma aç ç: : Wolff-Parkinson-White (WPW) sendromundaki aksesuar yolların (AP'ler) lokalizasyonu için doku Doppler görüntülemenin (TDI) tanısal doğruluğunu incelemeye çalıştık. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : EKG'sinde preeksitasyonu olan 35 hastayı prospektif olarak inceledik. Hastalar aksesuar yolun sol ventrikül serbest, septal ve sağ ventrikül serbest duvar olmak üzere üç gruba ayrıldı. TDI'da hastaların lateral mitral annulus, septal mitral annulus ve lateral triküspit annulustan alınan kayıtlar, elektrofizyolojik çalışma (EPS) da aksesuar yolun olduğu bölgelerle karşılaştırıldı. Ekokardiyografik incelemedeki elektromekanik interval (p-Sm) p dalgasının başlangıcı ile bölgesel miyokard kasılması (Sm) arasında geçen zaman olarak tanımlandı. B Bu ul lg gu ul la ar r: : EPS'de sol serbest aksesuar yol izlenen hastalarda, işlem öncesi TDI'da lateral mitral annulusta elektromekanik interval (pre p-Sm) diğer iki bölgeden (septal annulus ve sağ lateral triküspit annulus) anlamlı şekilde daha kısa saptandı (p=0.0001). EPS'de septal aksesuar yol saptanan ve sağ aksesuar yol saptanan hastalar...

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Section: Discussionmentioning

confidence: 99%

Localization of Accessory Pathway Using Tissue Doppler Echocardiography Prior Radiofrequency Ablation in Patients with Wolff-Parkinson-White Syndrome

Gül¹,

Eksik²,

Surgit³

et al. 2017

Turkiye Klinikleri J Cardiovasc Sci

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“…Different TDI modalities with M-mode Doppler, velocity mode, acceleration mode and pulsedwave Doppler have used for the detection of the accessory pathways in several studies [6][7][8][9][10][11].…”

Section: Discussionmentioning

confidence: 99%

“…The most frequent applications of TDI are in the evaluation of regional left ventricular (LV) systolic and diastolic functions [2][3][4][5]. Also, TDI offers the promise for the detection of the earliest ventricular contraction site and the time-squential changes in myocardial depolarization [6][7][8][9][10][11]. Several studies reported the ability of the color-coded TDI (velocity or acceleration map) or pulsed-wave TDI modalities to localize the site of the accessory atrioventricular pathways and to evaluate the results of radiofrequency ablation [6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

“…Also, TDI offers the promise for the detection of the earliest ventricular contraction site and the time-squential changes in myocardial depolarization [6][7][8][9][10][11]. Several studies reported the ability of the color-coded TDI (velocity or acceleration map) or pulsed-wave TDI modalities to localize the site of the accessory atrioventricular pathways and to evaluate the results of radiofrequency ablation [6][7][8][9][10][11]. Furthermore, recent studies have suggested a potential role of TDI technique to identify regional wall delay and predict improvement of systolic function or LV reverse remodeling after cardiac resynchronization therapy (CRT) in patients with chronic heart failure and a wide QRS complex [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

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Visualization of the site of the onset of ventricular depolarization by acceleration mode “Tissue Doppler Imaging” technique

Çavuşoğlu

Ata

Timuralp

et al. 2005

Int J Cardiovasc Imaging

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Tissue Doppler imaging (TDI) is a relatively new echocardiographic technique that shows regional myocardial wall velocities. The aim of this study was to evaluate the potential value of acceleration mode TDI technique for the visualization of the origin of ventricular activation site using the model of right ventricular pacing. Twenty-seven patients with implanted permanent pacemakers were studied by acceleration mode TDI, 4 of these patients were pacemaker dependent. Parasternal and apical chamber views were recorded on video tape by using acceleration mode TDI technique during sinus rhythm with preserved atrioventricular conduction in 23 subjects who were not pacemaker-dependent, and also during right ventricular apical pacing in VVI mode in 27 subjects in whom pacing lower rate was increased if necessary. Fifty images recorded during sinus and pacing rhythm in cineloop were examined by two independent observers who were unaware of the rhythm patterns and by the same observer on two different occasions for localizing the site of onset of ventricular acceleration. The origin of ventricular activation during sinus rhythm started at basal septal part of the ventricle and during pacing started at apical part of the ventricle was considered as correct localizations. The origin of ventricular depolarization was correctly localized for 46 of 50 images (92%) and 44 of 50 images (88%) by the first and the second observers, respectively. Concordant results between observers appeared in 48 of 50 (96%) of images. The diagnostic accuracy of the concordant results was 44 of 48 (91.6%) images. The kappa for interobserver variability was 0.77 (p<0.001), and for intraobserver variability was 0.64 (p<0.001) and 0.63 (p<0.001) for the first and the second observers, respectively. These results suggest that acceleration mode TDI can be used to detect the initial ventricular excited position and seems to have a potential value for localizing of the origin of normal or abnormal myocardial depolarization.

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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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Assessment of Accessory Atrioventricular Pathways by Doppler Myocardial Imaging

Cited by 12 publications

References 12 publications

Localization of Accessory Pathway Using Tissue Doppler Echocardiography Prior Radiofrequency Ablation in Patients with Wolff-Parkinson-White Syndrome

Localization of Accessory Pathway Using Tissue Doppler Echocardiography Prior Radiofrequency Ablation in Patients with Wolff-Parkinson-White Syndrome

Visualization of the site of the onset of ventricular depolarization by acceleration mode “Tissue Doppler Imaging” technique

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

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