医学
WPW综合征
算法
烧蚀
心脏病学
旁道
内科学
再现性
导管消融
心动过速
计算机科学
统计
数学
作者
Mustapha El Hamriti,Martin Braun,Stephan Molatta,Guram Imnadze,Moneeb Khalaph,Philipp Lucas,Julia Kathinka Nolting,Khuraman Isgandarova,Vanessa Sciacca,Thomas Fink,Leonard Bergau,Christian Sohns,Kunihiko Kiuchi,Makoto Nishimori,Christian Heeger,Martin Borlich,Dong‐In Shin,Sonia Busch,Denise Guckel,Philipp Sommer
出处
期刊:Europace
[Oxford University Press]
日期:2022-12-12
卷期号:25 (2): 600-609
被引量:6
标识
DOI:10.1093/europace/euac216
摘要
Abstract Aims Accessory pathway (AP) ablation is a standard procedure for the treatment of Wolff-Parkinson-White syndrome (WPW). Twelve-lead electrocardiogram (ECG)-based delta wave analysis is essential for predicting ablation sites. Previous algorithms have shown to be complex, time-consuming, and unprecise. We aimed to retrospectively develop and prospectively validate a new, simple ECG-based algorithm considering the patients’ heart axis allowing for exact localization of APs in patients undergoing ablation for WPW. Methods and results Our multicentre study included 211 patients undergoing ablation of a single manifest AP due to WPW between 2013 and 2021. The algorithm was developed retrospectively and validated prospectively by comparing its efficacy to two established ones (Pambrun and Arruda). All patients (32 ± 19 years old, 47% female) underwent successful pathway ablation. Prediction of AP-localization was correct in 197 patients (93%) (sensitivity 92%, specificity 99%, PPV 96%, and NPV 99%). Our algorithm was particularly useful in correctly localizing antero-septal/-lateral (sensitivity and specificity 100%) and posteroseptal (sensitivity 98%, specificity 92%) AP in proximity to the tricuspid valve. The accuracy of EASY-WPW was superior compared to the Pambrun (93% vs. 84%, P = 0.003*) and the Arruda algorithm (94% vs. 75%, P < 0.001*). A subgroup analysis of children (n = 58, 12 ± 4 years old, 55% female) revealed superiority to the Arruda algorithm (P < 0.001*). The reproducibility of our algorithm was excellent (ϰ>0.8; P < 0.001*). Conclusion The novel EASY-WPW algorithm provides reliable and accurate pre-interventional ablation site determination in WPW patients. Only two steps are necessary to locate left-sided AP, and three steps to determine right-sided AP.
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