AI Article Synopsis
- Accurate assessment of atrioventricular conduction time (AVCT) is essential for early detection of fetal heart block, typically measured using pulsed wave Doppler (PD) for left ventricular inflow and outflow.
- Limitations of PD include its sensitivity to loading conditions and its difficulty in differentiating between early and late diastolic inflow at higher heart rates, suggesting the potential benefits of using Doppler tissue imaging (DTI).
- A study on pigs found that DTI provided a better correlation with PR intervals and allowed for more reliable AVCT measurements at faster heart rates compared to PD, indicating that DTI could be a superior method for assessing AVCT across various heart rates.
Article Abstract
Accurate assessment of atrioventricular conduction time (AVCT) is crucial for early detection of evolving fetal heart block. Simultaneous pulsed wave Doppler (PD) interrogation of left ventricular inflow and outflow is mainly used to study fetal AVCT. Limitations of this modality include its dependency on loading conditions and merging early and late diastolic inflow waves at faster heart rate (HR). Sequential analysis of atrioventricular myocardial motion by Doppler tissue imaging (DTI) might be more useful in this regard. In 15 open-chest pigs, AVCT was measured by PD, DTI, and electrocardiogram at baseline HR and during incremental atrial pacing up to 200 beats/min. Electromechanical delay and pre-ejection period were assessed at baseline and maximal HR. DTI-derived AVCT correlated better with PR intervals and allowed measurements at faster HRs than did PD (P < .05). Pre-ejection period prolonged with faster HR (P < .001), unlike electromechanical delay. In conclusion, DTI allows more accurate measurement of AVCT over a wider HR range than does PD.
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| http://dx.doi.org/10.1016/j.echo.2005.09.010 | DOI Listing |
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