Abstract
OBJECTIVETo determine preoperatively, by analysing asynchronous left ventricular wall motion, whether to approach through the right ventricle or the left ventricle when carrying out catheter ablation of the accessory pathway...
Highlights
Left ventricular posterior wall motion was less when the site was located on the left ventricular side than on the right ventricular side (11.1 (1.7) v 12.9 (1.1) mm, p < 0.001)
ECG, radiofrequency catheter position, and M mode echocardiography tracings in a patient with a left posterior septal accessory pathway and in a patient with a right posterior septal pathway are shown in figs 2 and 3, respectively
A notch in the posterior wall systolic motion was observed all nine patients with a left posterior septal accessory pathway, while this was not found when the pathways were located on the right ventricular side of the septum
Summary
Cross sectional echocardiograms were recorded in 82 consecutive patients with manifest WPW syndrome who underwent successful catheter ablation. Radiofrequency catheter ablation was performed according to the established method.[1 2] In the case of a right sided accessory pathway, a right atrial approach was attempted. Notch movement and amplitude of systolic posterior wall motion, paradoxical septal motion, and notch movement and amplitude of systolic interventricular wall motion were defined as asynchronous systolic wall motion indices. To confirm these findings, we compared the findings before and after catheter ablation. Using the Oklahoma ECG algorithm[6] and the St George’s ECG algorithm,[7] the location of the accessory pathway was estimated by three cardiologists who were not aware of the clinical and electrophysiological findings in the patients examined. A probability (p) value of < 0.05 was regarded as significant
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