Role of speckle tracking in precise localization of accessory pathway in Wolff-Parkinson-White syndrome

Abstract

Background: The non-Doppler echocardiographic technique known as two-dimensional speckle tracking echocardiography (2D-STE) has been demonstrated to help assess dyssynchrony and allow quantification of cardiac deformity and timing in 2D greyscale images. This study evaluated the 2D speckle tracking role in the accessory pathway (AP) localization compared to the electrophysiology study (EPS) as the gold standard technique. Methods: This study was performed on patients with evident Wolff-Parkinson-White (WPW) syndrome who were recommended to undergo EPS and ablation. Patients were recruited based on results from the resting ECG, clinical history of recurrent palpitations, or an ECG with confirmed bouts of atrioventricular reentrant tachycardia (AVRT). The patients were evaluated using electrocardiography, conventional 2D echocardiography, and 2D-STE and were assessed for the possibility of ablation. Results: Thirteen patients were included (seven males and six females) with a mean age of 29.23 ± 9.3 years. All patients had a negative family history of WPW syndrome. ECG revealed that AP localization was posteroseptal in 4 patients (30.8%), anteroseptal in 3 (23.1%), right lateral in 2 (15.4%), left lateral in 1 (7.7%), anterolateral in 1 (7.7%), right posterior in 1 (7.7%), and left posterior in 1 (7.7%).