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Validation of New Algorithm to Localize the Site of the Accessory Pathway in Patients with Wolf Parkinson White syndrome Using Surface ECG

DOI: 10.5083ejcm20424884.170 , Cite or Link Using DOI
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Mohammed Hashim Hussein Almyahi, Ammar Salih Abbood, Firas R. AL-Obaidi, Ammar Talib Alhamdi, Tahsin Ali Al-kinani

Background: In patients with Wolf Parkinson White syndrome, localization of the site of accessory pathway using surface ECG is an important step prior to any Electrophysiological study and ablation therapy. Aims: To validate a new and simple stepwise algorithm in localizing the accessory pathway site using the surface ECG during sinus rhythm. Materials and Methods: A prospective study was conducted among patients with Wolf Parkinson White syndrome scheduled for electrophysiological study and ablation therapy at a single center from January 2015 to February 2019. The surface ECG of patients with Wolf Parkinson White syndrome, taken one day prior to the Electrophysiological study, were used to apply this algorithm to localize the site of accessory pathway and compare it with the results of Electrophysiological study next day. Results: The total number of patients enrolled in the study were 121;, of which 73 were males (60.3 %) and 48 females (39.7 %), with ameanageof33±12years&rangeof13-69 years. Overall sensitivity and specificity of this algorithm in detecting the site of accessory pathway, using successful ablation site as a reference test, were 94% and 98%, respectively, and the positive and negative predictive values were 90% and 99%, respectively. Conclusion: This new algorithm to localize the site of the accessory pathway in patients with Wolf Parkinson White syndrome using surface ECG is easily applied and has good sensitivity and specificity.