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Measurement of Ventricular Function by ECG Gating during Atrial Fibrillation

National Institutes of Health, Bethesda, Maryland

Correspondence: For reprints contact: Stephen L. Bacharach, PhD, National Institutes of Health, Dept. of Nuclear Medicine, Bldg. 10, Rm. 1B48, Bethesda, MD 20205.

ABSTRACT

The assumptions necessary to perform ECG-gated cardiac studies are seemingly not valid for patients in atrial fibrillation (AF). To evaluate the effect of AF on equilibrium gated scintigraphy, beat-by-beat measurements of left-ventricular function were made on seven subjects in AF (mean heart rate 64 bpm), using a high-efficiency nonimaging detector. The parameters evaluated were ejection fraction (EF), time to end-systole (TES), peak rates of ejection and filling (PER,PFR), and their times of occurrence (TPER,TPFR). By averaging together single-beat values of EF, PER, etc., it was possible to determine the true mean values of these parameters. The single-beat mean values were compared with the corresponding parameters calculated from one ECG-gated time-activity curve (TAC) obtained by superimposing all the single-beat TACs irrespective of their length. For this population with slow heart rates, we find that the values for EF, etc., produced from ECG-gated time-activity curves, are very similar to those obtained from the single-beat data. Thus use of ECG gating at low heart rates may allow reliable estimation of average cardiac function even in subjects with AF.

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