Key result
Radiofrequency catheter ablation shortened interventricular electromechanical delay from 21.5 ms to 14.0 ms (p=0.01), restoring cardiac synchrony in Wolff-Parkinson-White syndrome patients.
Why the study?
Does radiofrequency catheter ablation improve Doppler echocardiographic parameters and restore cardiac synchrony in patients with Wolff-Parkinson-White syndrome?
Observational (n=30)
No
Does radiofrequency catheter ablation improve Doppler echocardiographic parameters and restore cardiac synchrony in patients with Wolff-Parkinson-White syndrome?
Absolute Event Rate: 14% vs 21.5%
p-value: p=0.01
Radiofrequency catheter ablation in patients with WPW syndrome restores cardiac synchrony, which can be effectively evaluated using conventional Doppler echocardiographic time intervals.
Ablation may restore synchrony in WPW per Doppler measures; hypothesis-generating and requires RCTs before practice change.
The aim of this study was to compare the conventional Doppler echocardiographic parameters before and after accessory pathway ablation in patients with Wolff-Parkinson-White (WPW) syndrome. Thirty patients (19 males, 11 females) aged 35.5 +/- 14.4 years were enrolled in the study. All patients underwent successful radiofrequency catheter ablation (RFCA). Echocardiograhic examination was performed before and after RFCA. Aortic and pulmonary flows, diastolic early (E) and late (A) transmitral filling velocities, their velocity time integrals (VTI), mitral diastolic filling time (DFT), deceleration time (DT), isovolumic relaxation time (IVRT), aortic ejection time, and aortic VTI were assessed before and after RFCA. We found that the pulmonary valve opened earlier than the aortic valve when the accessory pathway was located on the right ventricular side (P = 0.02). Otherwise, if the accessory pathway was located on the left ventricular side, the aortic valve opened earlier (P < 0.01). Intervals between the onsets of aortic and pulmonary flows were shortened after RFCA (P = 0.01). We also observed prolongation of DFT (P < 0.001), increases in A velocity (P < 0.05) and its VTI (P < 0.01), as well as a decrease in the E/A ratio (P < 0.01) and shortening of aortic ejection time (P = 0.01) with restoration of AV conduction. We conclude that Doppler echocardiographic examination can provide clues about accessory pathway location and RFCA causes some significant changes in Doppler echocardiographic time intervals. These changes confirm that cardiac synchrony is restored after RFCA.
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Çakmak et al. (2007) conducted an observational in Wolff-Parkinson-White syndrome (n=30). Radiofrequency catheter ablation vs. Preablation baseline was evaluated on Interventricular electromechanical delay (∆QV interval) (p=0.01). Radiofrequency catheter ablation shortened interventricular electromechanical delay from 21.5 ms to 14.0 ms (p=0.01), restoring cardiac synchrony in Wolff-Parkinson-White syndrome patients.
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