Figure 5
Tricuspid annular tissue Doppler imaging pre cardioversion showing two
extra velocities, one with smaller amplitude preceding and one with
larger amplitude following annular e’ wave, both immediately following
the flutter P wave on the ECG prior to cardioversion (A). These waves
disappeared during sinus rhythm after cardioversion (B). These
velocities were almost unrecognizable on mitral inferolateral annular
Doppler pre cardioversion (C) and normal tissue Doppler mitral annular
pattern emergent post cardioversion (D). Restrictive appearing mitral
inflow pattern (E) and increased TR peak velocity of3.1 m/sec
corresponding to a pressure gradient of 38 mm Hg is shown (F). Due to
Doppler beam insonation angle of 60 degrees with the tricuspid annulus
there is Doppler signal noise most marked in A.