A new ECG algorithm for the localization of accessory pathways using only the polarity of the QRS complex

“…Iturralde et al 11 described an algorithm using an analysis of QRS polarity in leads III, V1 and V2 produced via a retrospective analysis of ECGs from 102 patients, mostly adults, undergoing RFA. They included only ECGs with a QRS duration >120 ms.…”

Section: Methodsmentioning

confidence: 99%

Accuracy of algorithms to predict accessory pathway location in children with Wolff–Parkinson–White syndrome

Wren

Vogel

Lord

et al. 2011

Heart

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“…The algorithm by D'Avila et al 14 (eight possible locations) and Iturralde et al 16 (five possible locations) emerged as those with highest agreement rates: 80% and 70%, respectively. The algorithms by Arruda et al., 11 Chiang et al., 13 and Fitzpatrick et al.…”

Section: Resultsmentioning

confidence: 88%

“…We analyzed seven electrocardiographic algorithms that locate noninvasively the AP in patients with WPW pattern, proposed by Arruda et al, 11 Boersma et al, 12 Chiang et al, 13 D'Avila et al, 14 Fitzpatrick et al, 15 Iturralde et al, 16 and Xie et al 17 The seven algorithms divide the AP annulus into 5-13 regions, using diverse combinations of criteria for analysis, namely, polarity of the QRS complex, amplitude and duration of the R wave, and amplitude and polarity of the delta wave. To accurately compare the algorithms, we used the 13 locations described by Chiang et al following the analogy proposed by Wren et al 9 (Table 1).…”

Section: Methodsmentioning

confidence: 99%

Accuracy of the Electrocardiogram in Localizing the Accessory Pathway in Patients with Wolff-Parkinson-White Pattern

Teixeira¹,

Pereira²,

Lebreiro

et al. 2016

Arquivos Brasileiros De Cardiologia

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BackgroundThere are currently several electrocardiographic algorithms to locate the accessory pathway (AP) in patients with Wolff-Parkinson-White (WPW) syndrome.ObjectiveTo compare the ability of electrocardiographic algorithms in identifying the location of the AP in patients with WPW pattern referred for ablation.MethodsObservational, cross-sectional, retrospective study with 111 patients with WPW syndrome referred for AP ablation. The electrocardiogram (ECG) obtained prior to the ablation was analyzed by an experienced observer who consecutively applied seven algorithms to identify non-invasively the AP. We then compared the location estimated with this assessment with that obtained in the electrophysiological study and calculated the agreement rates.ResultsAmong the APs, 59 (53.15%) were distributed around the mitral annulus and the remaining 52 (46.85%) were located around the tricuspid annulus. The overall absolute accuracy of the algorithms evaluated varied between 27% and 47%, increasing to between 40% and 76% when we included adjacent locations. The absolute agreement rate by AP location was 2.00-52.20% for septal APs (n = 51), increasing to 5.90-90.20% when considering adjacent locations; 7.70-69.20% for right APs (n = 13), increasing to 42.90-100% when considering adjacent locations; and 21.70-54.50% for left APs (n = 47), increasing to 50-87% when considering adjacent locations.ConclusionThe agreement rates observed for the analyzed scores indicated a low discriminative ability of the ECG in locating the AP in patients with WPW.

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“…10,[17][18][19] Previous reports demonstrate that the risk of causing complete AV block is around 36% in the case of pathways located close to the normal AV conduction system. 6,7,14,20,21 According to the standard classification, these are the anteroseptal and midseptal right accessory pathways, while a specific subgroup includes the parahisian pathways (1.4%), which are in the vicinity of the AV conduction system.…”

mentioning

confidence: 99%

Radiofrequency Catheter Ablation of Parahisian Accessory Pathway

Korodi

Kovács

Benedek³

et al. 2016

Journal of Interdisciplinary Medicine

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introductionPalpitation is a common symptom of Wolf-Parkinson White (WPW) syndrome. The presence of an accessory pathway (AP) contributes to the occurrence of episodes of atrioventricular (AV) re-entrant tachycardias, usually via the orthodromic type of re-entry mechanism. 1,2 In the general population, the prevalence of accessory pathway is 0.15% to 0.25%. 3,4 In pre-excitation syndromes radiofrequency (RF) catheter ablation is nowadays the routine treatment for AP-facilitated tachycardias. 5 Accessory pathways may be located close to the His bundle and the AV node, in the anteroseptal, midseptal, and parahisian regions. The ablation of these pathways is associated with a high risk of complete heart block, due to its proximity to the atrioventricular node. 2,[6][7][8][9] In this case report, we describe the case of a patient with intermittent preexcitation syndrome, caused by a parahisian accessory pathway. case reportA 32 year-old man, a professional driver, presented to our hospital with recurrent palpitations with sudden onset and termination, and two unregistered presyn- Radiofrequency Catheter ABSTRACTRadiofrequency catheter ablation of parahisian accessory pathways in pre-excitation syndrome is a challenging task, due to the extremely high risk of complete atrioventricular block. In this brief report we describe the case of a 32 year-old man presenting a parahisian accessory pathway, who has been successfully treated by radiofrequency ablation. Radiofrequency catheter ablation using low-power radiofrequency current is considered to be the most appropiate method of ablation in adult patients.

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A new ECG algorithm for the localization of accessory pathways using only the polarity of the QRS complex

Cited by 62 publications

References 13 publications

Accuracy of algorithms to predict accessory pathway location in children with Wolff–Parkinson–White syndrome

Accuracy of algorithms to predict accessory pathway location in children with Wolff–Parkinson–White syndrome

Accuracy of the Electrocardiogram in Localizing the Accessory Pathway in Patients with Wolff-Parkinson-White Pattern

Radiofrequency Catheter Ablation of Parahisian Accessory Pathway

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