Doppler-echocardiographic assessment of cardiac pacemakers.

A complete echocardiography laboratory now offers not only M-mode and two-dimensional echocardiography but also pulsed, continuous-wave, and color Doppler flow mapping. There are innumerable practical applications of these combined modalities to the clinical management of patients with pacemakers. These include not only the anatomic documentation of lead position and diagnosis of perforations but also evaluation of pacing-related hemodynamics on a beat-to-beat basis. This is particularly valuable for "fine-tuning" multiprogrammable features of the pacing system in an individual patient.