Echocardiography in Wolff-Parkinson-White syndrome.

Abstract

SUMMARY Twenty-six patients with Wolff-Parkinson-White (WPW) syndrome were studied by echocardiography. They were classified into the following WPW types: anterior right ventricular pre-excitation ( Since its recognition in 1930 there have been numerous reports of cardiac abnormalities associated with WPW. These include Ebstein's anomaly, tricuspid atresia, ventricular septal defect, atrial septal defect, coarctation of the aorta, corrected transposition of the great vessels, tetralogy of Fallot and idiopathic hypertrophic subaortic stenosis.9'0 The true incidence of these conditions associated with WPW is unknown.The purposes of this study were to utilize echocardiography to determine the motion of the interventricular septum in WPW, and to assess the incidence of cardiac abnormalities associated with the WPW syndrome. MethodsPatients were identified by reviewing the ECG files at the University of Iowa Hospital and Veterans Administration Hospital in Iowa City. Preliminary ECG criteria for identification were a P-R interval of less than 0.12 sec and a delta wave. No attempts were made to select patients by age, sex or cardiac diagnosis. All patients with at least one ECG meeting these preliminary criteria were contacted by letter and telephone; 26 responded and these were the subjects of the study.All 26 patients underwent physical examination, 12 lead scalar electrocardiography, Frank system vectorcardiog-

Septal Dyskinesia and Global Left Ventricular Dysfunction in Pediatric Wolff‐Parkinson‐White Syndrome with Septal Accessory Pathway

“…Echocardiography has been used to investigate abnormal wall motion in a limited number of studies. [1][2][3][4] Abnormalities of interventricular septal motion in WPW syndrome may result in global left ventricular (LV) dysfunction mimicking dilated cardiomyopathy. 4,5 Radiofrequency catheter ablation (RFA) of APs is an established first-line therapy for symptomatic tachycardia in children.…”

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

“…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.…”

“…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.…”

Two-dimensional echocardiographic phase analysis. Its potential for noninvasive localization of accessory pathways in patients with Wolff-Parkinson-White syndrome.

“…Therefore, these potentially confounding conditions must be excluded, especially when dealing with septal pathways. 32 Furthermore, the earliest sites of retrograde atrial activation determined by endocardial mapping may not be precisely identical with the ventricular insertion site of accessory connections. This limitation would appear to result in relatively minor discrepancies33 well below the error of measurement using the phase image technique.…”