title: Noninvasive localization of accessory pathways in patients with Wolff-Parkinson-White syndrome with the use of myocardial Doppler imaging.
abstract: This study sought to examine the diagnostic accuracy of noninvasive prediction of accessory pathway localization in patients with manifest Wolff-Parkinson-White syndrome with the use of myocardial Doppler imaging as a new noninvasive mapping procedure. Myocardial Doppler imaging measures myocardial velocities and therefore can determine the site of earliest ventricular activation 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 electromechanical time interval in 9 basal myocardial segments. The new diagnostic test was compared with 3 electrocardiographic algorithms. An invasive mapping procedure served as reference standard. Abnormally short electromechanical time intervals were found in preexcited segments (27 +/- 12 ms vs 64 +/- 27 ms). Myocardial Doppler imaging correctly localized 84% of the accessory pathways and electrocardiographic algorithms only 48% to 60% of cases. Noninvasive prediction of accessory pathway localization by myocardial Doppler imaging is accurate and proved to be superior to prediction based on electrocardiographic algorithms.
authors.affiliation: 1 Medizinische Klinik, Klinikum rechts der Isar and Deutsches Herzzentrum, Technische Universität München, Munich, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Tuchnitz
authors.forename: C
authors.initials: C
authors.lastname: Schmitt
authors.forename: H
authors.initials: H
authors.lastname: von Bibra
authors.forename: M A
authors.initials: MA
authors.lastname: Schneider
authors.forename: A
authors.initials: A
authors.lastname: Plewan
authors.forename: A
authors.initials: A
authors.lastname: Schömig
mesh_terms: D000328:Adult; D000465:Algorithms; D018780:Body Surface Potential Mapping; D004452:Echocardiography; D015150:Echocardiography, Doppler; D018618:Echocardiography, Doppler, Color; D018619:Echocardiography, Doppler, Pulsed; D004562:Electrocardiography; D005260:Female; D005544:Forecasting; D006329:Heart Conduction System / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D009200:Myocardial Contraction / Q000502:physiology; D011446:Prospective Studies; D012008:Recurrence; D013617:Tachycardia, Supraventricular / Q000000981:diagnostic imaging / Q000503:physiopathology; D013997:Time Factors; D016276:Ventricular Function / Q000502:physiology; D014927:Wolff-Parkinson-White Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology