篇名 | A Novel and Simple Algorithm Using Surface Electrocardiogram That Localizes Accessory Conduction Pathway in Wolff-Parkinson-White Syndrome in Pediatric Patients |
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卷期 | 35:5 |
作者 | Hsing-Yuan Li 、 Shih-Lin Chang 、 Chi-Hsi Chuang 、 Ming-Chih Lin 、 Yenn-Jiang Lin 、 Li-Wei Lo 、 Yu-Feng Hu 、 Fa-Po Chung 、 Yao-Ting Chang 、 Chieh-Mao Chung 、 Shih-Ann Chen 、 Pi-Chang Lee |
頁次 | 493-500 |
關鍵字 | Accessory pathway 、 Algorithm 、 Children 、 Localization 、 WPW syndrome 、 MEDLINE 、 Scopus 、 SCIE |
出刊日期 | 201909 |
DOI | 10.6515/ACS.201909_35(5).20190312A |
Background: The location of the accessory pathway (AP) can be precisely identified on surface electrocardiography (ECG) in adults with Wolff-Parkinson-White (WPW) syndrome. However, current algorithms to locate the AP in pediatric patients with WPW syndrome are limited. Objective: To propose an optimal algorithm that localizes the AP in pediatric patients with WPW syndrome. Methods: From 1992 to 2016, 180 consecutive patients aged below 18 years with symptomatic WPW syndrome were included. After the exclusion of patients with non-descriptive electrocardiography (ECG),multiple APs, congenital heart diseases, non-inducible tachycardia, and those who received a second ablation, 104 patients were analyzed retrospectively. Surface ECG was obtained before ablation and evaluated by using previously documented algorithms, from which a new pediatric algorithm was developed. Results: Previous algorithms were not highly accurate when used in pediatric patients with WPW syndrome. In the new algorithm, the R/S ratio of V1 and the polarity of the delta wave in lead I could distinguish right from the left side AP with 100% accuracy. The polarity of the delta wave of lead V1 could distinguish free wall AP from septal AP with an accuracy of 100% in left-side AP, compared to 88.6% in leads III and V1 for right-side AP. The overall accuracy was 92.3%. Conclusions: This simple, novel algorithm could differentiate left from right AP and septal from free wall AP in pediatric patients with WPW syndrome.