Affiliation:
1. Arrhythmia & Electrophysiology Center IRCCS MultiMedica Sesto San Giovanni Milan Italy
2. Department of Clinical and Molecular Medicine, Division of Cardiology, St. Andrea Hospital Sapienza University Rome Italy
3. Cardiovascular Department Assiut University Assiut Egypt
Abstract
AbstractIntroductionDespite numerous ECG algorithms being developed to localize the site of manifest accessory pathways (AP), they often require stepwise multiple‐lead analysis with variable accuracy, limitations, and reproducibility. The study aimed to develop a single‐lead ECG algorithm incorporating the P‐Delta interval (PDI) as an adjunct criterion to discriminate between right and left manifest AP.MethodsConsecutive WPW patients undergoing electrophysiological study (EPS) were retrospectively recruited and split into a derivation and validation group (1:1 ratio). Sinus rhythm ECG analysis in lead V1 was performed by three independent investigators blinded to the EPS results. Conventional ECG parameters and PDI were assessed through the global cohort.ResultsA total of 140 WPW patients were included (70 for each group). A score‐based, single‐lead ECG algorithm was developed through derivation analysis incorporating the PDI, R/S ratio, and QRS onset polarity in lead V1. The validation group analysis confirmed the proposed algorithm's high accuracy (95%), which was superior to the previous ones in predicting the AP side (p < 0.05). A score of ≤+1 was 96.5% accurate in predicting right AP while a score of ≥+2 was 92.5% accurate in predicting left AP. The new algorithm maintained optimal performance in specific subgroups of the global cohort showing an accuracy rate of 90%, 92%, and 96% in minimal pre‐excitation, posteroseptal AP, and pediatric patients, respectively.ConclusionsA novel single‐lead ECG algorithm incorporating the PDI interval with previous conventional criteria showed high accuracy in differentiating right from left manifest AP comprising pediatric and minimal pre‐excitation subgroups in the current study.
Subject
Physiology (medical),Cardiology and Cardiovascular Medicine
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献