Abstract
It has been suggested that phase analysis of radionuclide ventriculograms may be of value for detecting and localising the abnormal sequence of ventricular contraction secondary to Wolff-Parkinson-White (WPW) syndrome. The present study was undertaken to test this hypothesis. The space-time sequences of right- and left-ventricular action obtained from radionuclide ventriculograms obtained during rest studies were evaluated in 8 patients with WPW syndrome (confirmed by 12-lead surface electrocardiography) and compared to those of 14 normal subjects. All of the latter showed a consistent ventricular activation pattern, i.e. the first site of ventricular activity in the upper septal region followed by a second site either at the base of the left ventricle or located apically. It was possible to diagnose 11 of the 14 normal subjects (specificity, 79%) and 7 of the 8 patients (sensitivity, 88%). The 4 patients who had been classified as having a left-sided accessory bundle by surface electrocardiography were likewise diagnosed by phase analysis, as were the 2 patients with a confirmed right-sided bypass tract. Two patients with septal posterior accessory pathways could not be identified by phase analysis. Furthermore, cases with an activation pattern which closely resembled that of the 2 patients with right-sided accessory bundles were found to be normal from their ECGs. It is now necessary to evaluate phase analysis against invasive electrophysiological methods in such patients.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Adam WE, Bitter F (1981a) Methods and instrumentation for imaging of cardiovascular function. Proceedings of the 28th Annual Meeting of the Society of Nuclear Medicine, Las Vegas
Adam WE, Bitter F (1981b) Advances in heart imaging. In: Medical radionuclide imaging 1980. IAEA, Vienna, pp 195–218
Bitter F, Adam WE, Geffers H, Weller R (1980) Die Fourieranalyse bei der Auswerkung von Herzuntersuchungen. In: Proceed 7. Frühjahrstagung Deutsche Gesellschaft für Med Dokumentation, Informatik und Statistik. EV, Munich
Botvinick EH, Dunn R, O'Connell W, Shosa D, Tucker C, Herfkens R (1980) The phase image-— its relationship to patterns of contraction and conduction. Circulation (suppl 3) 65:551–560
Botvinick EH, Frais MA, Shosa DW, O'Connell JW, Pacheco-Alvarez JA, Scheinman M, Hattner RS, Morady F, Faulkner DB (1982) An accurate means of detecting and characterizing abnormal patterns of ventricular activation by phase image analysis. Am J Cardiol 50:289–298
Chan W, Kalff V, MacDonald D, Rabinovitch M, Jenkins J, Thrall J, Pitt B (1983) Topography of preemptying ventricular segments in patients with Wolff-Parkinson-White syndrome using scintigraphic phase mapping and esophageal pacing. Circulation 67:1139–1146
Clare J, Chan W, Kalff V (1981) Use of phase images in the display of conduction and contraction abnormalities. J Nucl Med Technol 9:111–115
Clayton PD, Bulawa WF, Klausner SC, Urie PM, Marshall HW, Warner HR (1979) The characteristic sequence for the onset of contraction in the normal human left ventricle. Circulation 59:671–679
Cobb FR, Blumenschein SD, Sealy WC, Bonean JP, Wagner GS, Wallace AG (1968) Successful surgical interruption of the bundle of Kent in a patient with Wolff-Parkinson-White syndrome. Circulation 38:1018–1029
Durrer D, Roos JP (1967) Epicardial excitation of the ventricles in a patient with Wolff-Parkinson-White syndrome (Type B). Circulation 35:15–21
Fontaine G, Guirandon G, Frank R, Coutle R, Dragodonne C (1967) Epicardial mapping and surgical treatment in six cases of resistant ventricular tachycardia not related to coronary artery disease. In: Wellens HJJ, Lie KL, Janse MJ (eds) The conduction system of the heart Lea and Febiger, Philadelphia, pp 545–563
Frais MA, Botvinick E, O'Connell JW, Shosa DW, Scheinmann NM, Hattner RS (1981) The phase image: an accurate means of detecting and localizing abnormal foci of ventricular activation. J Nucl Med 22:P18
Gallagher JJ, Gilbert M, Svenson RH, Sealy WC, Kassel J, Wallace AG (1975) Wolff-Parkinson-White syndrome: the problem, evaluation and surgical correction. Circulation 51: 767–785
Gallagher JJ, Pritchett ELC, Sealy WC, Kassel J Wallace AG (1978) The pre-excitation syndromes. Prog Cardiovasc Dis 20:285–327
Josephson ME, Horowitz LN, Farshidi A, Spear JF, Kastor JA, Moore EN (1978) Recurrent sustained ventricular tachycardia. II. Endocardial mapping. Circulation 57:440–447
Links JM, Douglas KH, Wagner HN Jr (1980) Patterns of ventricular emptying by Fourier analysis of gated blood pool studies. J Nucl Med 21:978–982
Pavel D, Swiryn S, Byrom E (1980a) Phase analysis in radionuclide cardiac gated studies in patients with normal and abnormal electrical activation of the heart. J Nucl Med 21: P73
Pavel D, Swiryn S, Lam W, Byrom E, Sheikh A, Rosen K (1980b) Ventricular phase analysis of radionuclide gated studies. Am J Cardiol 45:398
Rosenbaum FF, Hecht HH, Wilson FN, Johnston FD, Arbor A (1945) The potential variations of the thorax and the esophagus in anomalous atrioventricular excitation (Wolff-Parkinson-White syndrome). Am Heart J 29:281–326
Tonkin AM, Wagner GS, Gallagher JJ, Cope GD, Kassel J, Wallace AG (1975) Initial forces of ventricular depolarisation in the Wolff-Parkinson-White syndrome. Analysis based upon localization of the accessory pathway by epicardial mapping. Circulation 52:1030–1036
Author information
Authors and Affiliations
Additional information
This work was made possible by an award by the Alexander von Humboldt Stiftung
Rights and permissions
About this article
Cite this article
Dormehl, I.C., Bitter, F., Henze, E. et al. An evaluation of the diagnostic efficacy of phase analysis of data from radionuclide ventriculograms in patients with Wolff-Parkinson-White syndrome. Eur J Nucl Med 11, 150–155 (1985). https://doi.org/10.1007/BF00251365
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00251365