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A Novel and Simple Algorithm Using Surface Electrocardiogram That Localizes Accessory Conduction Pathway in Wolff-Parkinson-White Syndrome in Pediatric Patients.
A Novel and Simple Algorithm Using Surface Electrocardiogram That Localizes Accessory Conduction Pathway in Wolff-Parkinson-White Syndrome in Pediatric Patients.
- Source :
-
Acta Cardiologica Sinica [Acta Cardiol Sin] 2019 Sep; Vol. 35 (5), pp. 493-500. - Publication Year :
- 2019
-
Abstract
- Background: The location of the accessory pathway (AP) can be precisely identified on surface electrocardiography (ECG) in adults with Wolff-Parkinson-White (WPW) syndrome. However, current algorithms to locate the AP in pediatric patients with WPW syndrome are limited.<br />Objective: To propose an optimal algorithm that localizes the AP in pediatric patients with WPW syndrome.<br />Methods: From 1992 to 2016, 180 consecutive patients aged below 18 years with symptomatic WPW syndrome were included. After the exclusion of patients with non-descriptive electrocardiography (ECG), multiple APs, congenital heart diseases, non-inducible tachycardia, and those who received a second ablation, 104 patients were analyzed retrospectively. Surface ECG was obtained before ablation and evaluated by using previously documented algorithms, from which a new pediatric algorithm was developed.<br />Results: Previous algorithms were not highly accurate when used in pediatric patients with WPW syndrome. In the new algorithm, the R/S ratio of V1 and the polarity of the delta wave in lead I could distinguish right from the left side AP with 100% accuracy. The polarity of the delta wave of lead V1 could distinguish free wall AP from septal AP with an accuracy of 100% in left-side AP, compared to 88.6% in leads III and V1 for right-side AP. The overall accuracy was 92.3%.<br />Conclusions: This simple, novel algorithm could differentiate left from right AP and septal from free wall AP in pediatric patients with WPW syndrome.
Details
- Language :
- English
- ISSN :
- 1011-6842
- Volume :
- 35
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Acta Cardiologica Sinica
- Publication Type :
- Academic Journal
- Accession number :
- 31571798
- Full Text :
- https://doi.org/10.6515/ACS.201909_35(5).20190312A