tailieunhanh - Development and validation of a new algorithm in localizing accessory pathway in typical wolff-parkinson-white syndrome

Objectives: To develop a simple algorithm for localizing accessory pathways (APs) in the typical Wolff-Parkinson-White (WPW) syndrome using 12-lead electrocardiogram (ECG) and to test the accuracy of the newly built algorithm prospectively. | Journal of military pharmaco-medicine No7-2017 DEVELOPMENT AND VALIDATION OF A NEW ALGORITHM IN LOCALIZING ACCESSORY PATHWAY IN TYPICAL WOLFFPARKINSON-WHITE SYNDROME Chu Dung Si*; Pham Quoc Khanh**; Tran Van Dong** SUMMARY Objectives: To develop a simple algorithm for localizing accessory pathways (APs) in the typical Wolff-Parkinson-White (WPW) syndrome using 12-lead electrocardiogram (ECG) and to test the accuracy of the newly built algorithm prospectively. Subjects and methods: 298 patients with typical WPW syndrome were enrolled. The ECG parameters of 189 patients with a single anterograde AP that were confirmed by successful radio frequency (RF) catheter ablation were analysed to build a new ECG algorithm for localizing APs. Then this algorithm was tested prospectively in other 109 patients comparing with the localization of APs by RF ablation. Results: In 189 patients analyzed: the sensitivity and specificity of Delta wave polarity in V1 in predicting left or right APs were and , respectively; the sensitivity and specificity of QRS transition in predicting septal or lateral APs were and , respectively; the sensitivity and specificity of Delta wave polarity in inferior leads in predicting anterior or posterior APs were 100% and , respectively. The validation of the new algorithm based on the above ECG parameters in other 109 patients showed the sensitivity of and the specificity of 100%. Conclusion: Delta wave polarity in V1 and inferior leads combined with QRS complex transition were used to develop a new ECG algorithm for localizing AP. This new algorithm can be used to localize accessory pathways with high accuracy. * Keywords: Wolff-Parkinson-White syndrome; Algorithm; 12-lead electrocardiogram. INTRODUCTION Wolff-Parkinson-White (WPW) syndrome associated with an accessory AV connection (called Kent Bundle); the 12-lead ECG is characterized by a shortened PR, prolonged QRS, with Delta wave [1, 2]. Nowadays, radiofrequency