[Comparative study of 3 algorithms to localize the accessory pathway in Wolff-Parkinson-White syndrome].
OBJECTIVE
Some electrocardiographic algorithms have been developed to predict the location of the accessory pathway in the WPW syndrome. Few studies address the interobserver variability of such algorithms and the possible observer-dependent changes of accuracy. This study analyzes three algorithms to localize accessory pathways recently published, comparing the inter-observer variability, their predictive value and the most frequent problems observed during their application.


METHODS
Ninety-six electrocardiograms from patients who underwent successful ablation of a single accessory pathway were reviewed. The location of each pathway was predicted by two independent observers according to three different reported electrocardiographic algorithms. The interobserver agreement, percentage of correct predictions and critical steps of each algorithm were analyzed.


RESULTS
The interobserver agreement varied between 64 and 79% and the accuracy between 38 and 67%. The best results were obtained in the left lateral accessory pathways (69 to 89% correctly located). All the algorithms presented critical steps at which more than 20% of pathways were incorrectly classified.


CONCLUSIONS
The analyzed algorithms present a high interobserver variability. The accuracy obtained is clearly lower than that reported by the corresponding authors. These facts should be considered when being used them in clinical settings.
Alvarez López
M
M
Departmento de Cardíologia, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense, Madrid.
García Alberola
A
A
Tercedor
L
L
Arenal
A
A
Pérez Villacastín
J
J
Almendral
J
J
Delcán
J L
JL
D000328:Adult; D000465:Algorithms; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014927:Wolff-Parkinson-White Syndrome / Q000473:pathology* / Q000503:physiopathology*
Estudio comparativo de tres algoritmos de localización de la vía accesoria en el síndrome de Wolff-Parkinson-White.