title: LV dyssynchrony as assessed by phase analysis of gated SPECT myocardial perfusion imaging in patients with Wolff-Parkinson-White syndrome.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China. chenchunjsnj@163.com
authors.forename: Chun
authors.initials: C
authors.lastname: Chen
authors.forename: Dianfu
authors.initials: D
authors.lastname: Li
authors.forename: Changqing
authors.initials: C
authors.lastname: Miao
authors.forename: Jianlin
authors.initials: J
authors.lastname: Feng
authors.forename: Yanli
authors.initials: Y
authors.lastname: Zhou
authors.forename: Kejiang
authors.initials: K
authors.lastname: Cao
authors.forename: Michael S
authors.initials: MS
authors.lastname: Lloyd
authors.forename: Ji
authors.initials: J
authors.lastname: Chen
mesh_terms: D058606:Accessory Atrioventricular Bundle / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D000328:Adult; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography / Q000379:methods; D017115:Catheter Ablation / Q000379:methods; D004452:Echocardiography / Q000379:methods; D004562:Electrocardiography / Q000379:methods; D022062:Electrophysiologic Techniques, Cardiac / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D014927:Wolff-Parkinson-White Syndrome / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi