Can we improve the accuracy of electrocardiographic algorithms for accessory pathway location in children?
Kardiol Pol
; 80(1): 33-40, 2022.
Article
em En
| MEDLINE
| ID: mdl-34856632
ABSTRACT
BACKGROUND:
Predicting an accessory pathway location is extremely important in pediatric patients.AIMS:
We designed a study to compare previously published algorithms by Arruda, Boersma, and Chiang.METHODS:
This multicenter study included patients who had undergone successful ablation of one accessory pathway. Analysis of resting 12-lead electrocardiograms was carried out. An aggregated prediction score was constructed on the basis of algorithm agreement, and a structured workflow approach was proposed.RESULTS:
The total population was 120 patients (mean age, 12.7 [± 3.6] years). The algorithm by Boersma had the highest accuracy (71.7%). The inter-rater agreement among the 3 reference algorithms, according to left-sided accessory pathway (AP) identification, was good between Boersma and Chiang (κ = 0.611; 95% confidence interval [CI], 0.468-0.753) but moderate between Arruda and Chiang and between Arruda and Boersma (κ = 0.566; 95% CI, 0.419-0.713 and κ = 0.582; 95% CI, 0.438-0.727, respectively). Regarding locations at risk of atrioventricular (AV) block, agreement was fair between Arruda and Chiang and between Boersma and Chiang (κ = 0.358; 95% CI, 0.195-0.520 and κ = 0.307; 95% CI, 0.192-0.422, respectively) but moderate between Arruda and Boersma (κ = 0.45; 95% CI, 0.304-0.597). On applying a first-step diagnostic evaluation, when concordance was achieved, we were able to correctly identify left-sided or non-left-sided ablation sites in 96.4% (n = 80) of cases. When concordance was achieved, correct prediction of risk/no risk of AV block was achieved in 92.2% (n = 59) of cases.CONCLUSIONS:
An aggregated prediction score based on 3 reference algorithms proved able to predict an accessory pathway location very precisely and could be used to plan safely invasive procedures.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Síndrome de Wolff-Parkinson-White
/
Ablação por Cateter
/
Feixe Acessório Atrioventricular
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Prognostic_studies
Limite:
Child
/
Humans
Idioma:
En
Revista:
Kardiol Pol
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Itália