Abstract

Objectives: This study was designed characteristics of 12-lead Electrocardiogram (ECG) for the left free wall lateral of accessory pathway (AP) localization in the typical WPW syndrome to develop a new algorithm ECG for localizing APs, and to test the accuracy of the algorithm prospectively.


Methods: We studied 129 patients, in 84 patients with typical WPW syndrome have a single anterograde with the localization of APs identified by successful radiofrequency catheter ablation (RCFA) to develop a new ECG algorithm for the left free wall of localizing APs. Then this algorithm was tested prospectively in 45 patients were compared with the location of AP’s successful ablation by RCFA.


 Results: We found that the 12 lead ECG parameters in typical WPW syndrome such as delta wave polarity in V1, R/S ratio in V1, the transition of the QRS complex, delta wave polarity in inferior leads in diagnosis for the localization of APs by with high accuracy predicted from 74,5% to 100%, and for development of a new ECG algorithm. Then the following 45 patients were prospectively evaluated by the new derived algorithm for the left free wall pathways with high sensitivity and specificity from 75% to 100%.


Conclusion: 12-lead ECG parameters in typical WPW syndrome closely related to left free wall of APs localization, in order to develop the new ECG algorithm by parameters as above; and can be used to a new ECG algorithm in predicting the location APs with high accuracy.

Keywords: 12-lead ECG accessory pathway Localization Left free wall Medicine WPW syndrome

References

1. Borys Surawicz et al (2008), Chou’s Electrocardiography in clinical practice: Adult and Pediatric, Elservier Saunders
2. Basiouny Tarex et al (2012). Prospective Validation of A Sezer ECG Algorithm For Localization of Accrssory Pathways in Patients With Wolff-Parkinson-White Syndrome. AAMJ. 10, Suppl-2
3. Noriko Taguchi, Yasuya Inden et al (2013). A simple algorithm for localizing accessory pathways in patients with Wolff-Parkinson-White syndrome using only the R/S ratio. Journal of Arrhythmia
4. Andre D’avila, Vassilis Skeberis et al (1995). A Fast and Reliable Algorithm to Localize Accessory Pathways Based on the Polarity of the QRS Complex on the Surface ECG During Sinus Rhythm. Pace. 18
5. Robert Lermery, Douglas L Wood et al. (1987). Value of the resting 12 lead electrocardiogram and vectorcardiogram for locating the accessory pathway in patients with the Wolff – Parkinson – White. Bristish Heart Journal 58, 324-332

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