Comparative study of eight sets of ECG criteria for the localization of the accessory pathway in Wolff-Parkinson-White syndrome.
Eight sets of electrocardiographic (ECG) criteria for the localization of accessory conduction pathway (ACP) were evaluated on 182 patients with a single ACP. The Rosenbaum criteria identified 78.6% of the left-sided and 94.0% of the right-sided ACPs. Four of the other seven sets of criteria demonstrated a sensitivity higher than 70.9% and six showed a specificity higher than 74.9% in the 4-region ACP localization. The ECG feature of the delta wave polarity in lead V1 correctly localized the ACP to one of three broad regions in 162 of 182 patients with an overall specificity of 94.5%. The study indicates that (1) the 12-lead ECG is of practical value for initial ACP localization; (2) a type A ECG is almost invariably associated with a left-sided ACP, while type B may occur with any ACP location; (3) the polarity of the delta wave is the most important ECG feature, and the polarities of the delta wave and main QRS complex in lead V1 play an important role in ACP localization.
Yuan
S
S
Department of Surgery (I), Kanazawa University School of Medicine, Japan.
Iwa
T
T
Tsubota
M
M
Bando
H
H
D000328:Adult; D002304:Cardiac Pacing, Artificial; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D011300:Preoperative Care; D012680:Sensitivity and Specificity; D014927:Wolff-Parkinson-White Syndrome / Q000175:diagnosis* / Q000503:physiopathology