Algorithms to Identify Accessory Pathways' Location on the 12-Lead Electrocardiogram

Crinion, Derek; Baranchuk, Adrián

doi:10.1016/j.ccep.2020.08.007

Cited by 7 publications

(7 citation statements)

References 20 publications

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“…It should be mentioned that all the algorithms published before the year 2018 have used only the traditional fluoroscopic projections to correctly locate the AP during the EPS with RFCA. This method of fluoroscopic projections has important limitations due to anatomical variations among patients such as body habitus and heart rotation 17,18 , precisely the QRS-polarity algorithm, being one of the first, has these limitations. That is why all the algorithms could be validated using an electroanatomical mapping system.…”

Section: Discussionmentioning

confidence: 99%

Validation of qrs-polarity algorithm with special emphasis in parahisian pathways

Gómez-Flores¹,

Cueva-Parra²,

Gallegos-Cortéz³

et al. 2023

ACM

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Background: In 1996 Iturralde et al. published an algorithm based on the QRS polarity to determine the location of the accessory pathways (AP), this algorithm was developed before the massive practice of invasive electrophysiology. Purpose: To validate the QRS-Polarity algorithm in a modern cohort of subjects submitted to radiofrequency catheter ablation (RFCA). Our objective was to determinate its global accuracy and its accuracy for parahisian AP. Methods: We conducted a retrospective analysis of patients with Wolff-Parkinson-White (WPW) syndrome who underwent an electrophysiological study (EPS) and RFCA. We employed the QRS-Polarity algorithm to predict the AP anatomical location and we compared this result with the real anatomic location determined in the EPS. To determine accuracy, the Cohen's kappa coefficient (κ) and the Pearson correlation coefficient were used. Results: A total of 364 patients were included (mean age 30 years, 57% male). The global κ score was 0.78 and the Pearson's coefficient was 0.90. The accuracy for each zone was also evaluated, the best correlation was for the left lateral AP (κ of 0.97). There were 26 patients with a parahisian AP, who showed a great variability in the ECG features. Employing the QRS-Polarity algorithm, 34.6% patients had a correct anatomical location, 42.3% had an adjacent location and only 23% an incorrect location. Conclusion: The QRS-Polarity algorithm has a good global accuracy; its precision is high, especially for left lateral AP. This algorithm is also useful for the parahisian AP.

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Section: Discussionmentioning

confidence: 99%

Validation of qrs-polarity algorithm with special emphasis in parahisian pathways

Gómez-Flores¹,

Cueva-Parra²,

Gallegos-Cortéz³

et al. 2023

ACM

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“…33 Existem vários algoritmos para a localização da via acessória, baseados na polaridade do QRS ou da via anômala. [34][35][36] Devemos lembrar que entidades podem simular a presença de pré-excitação (falsos WPW) como a cardiomiopatia hipertrófica e formas familiares de depósito septal de glicogênio (doença de Fabry).…”

Section: Pré-excitação Ventricular 27-30unclassified

Diretriz da Sociedade Brasileira de Cardiologia sobre a Análise e Emissão de Laudos Eletrocardiográficos – 2022

Samesima¹,

God²,

Kruse³

et al. 2022

Arquivos Brasileiros De Cardiologia

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“…Ferrari et al [7] allow us to draw conclusions that are aligned with our recently published approach [6]. Our Simplified Topographic Algorithm (STA) aimed to provide a perspective on ECG location in the context of today's improved procedural tools to assist with EPS and ablations.…”

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confidence: 95%

“…This allows the operator to consider additional tools or methods that may be necessary during the intervention (i.e. transeptal puncture [TSP], use of cryoablation, use of coronary sinus [CS] venograms, coronary angiography) or to determine the risk of AV node block due to the proximity of the AP to the conduction system [6].…”

mentioning

confidence: 99%

“…In that article, we discussed the reasons why older AP location algorithms have important limitations such as anatomical variation (especially in children), inconsistent anatomical nomenclature, degree of pre-excitation affecting the ability to locate pathways, technical aspects (e.g. lead positioning), differences in the approaches for mapping (surgical or endocardial), the requirement for atrial pacing during the ablation procedure, septal locations and understudy of pediatric populations [6]. From our perspective, before an AP ablation procedure, the interventional electrophysiologist must consider the following:…”

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confidence: 99%

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Accessory pathway location algorithms: Planning invasive procedures in the electrophysiology laboratory

2022

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Algorithms to Identify Accessory Pathways' Location on the 12-Lead Electrocardiogram

Cited by 7 publications

References 20 publications

Validation of qrs-polarity algorithm with special emphasis in parahisian pathways

Validation of qrs-polarity algorithm with special emphasis in parahisian pathways

Diretriz da Sociedade Brasileira de Cardiologia sobre a Análise e Emissão de Laudos Eletrocardiográficos – 2022

Accessory pathway location algorithms: Planning invasive procedures in the electrophysiology laboratory

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