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Erschienen in: Journal of Interventional Cardiac Electrophysiology 1/2020

15.11.2019 | Electrocardiography

Estimation of the accessory pathway location of the manifest Wolf-Parkinson-White syndrome using synthesized right-sided chest leads

verfasst von: Masahiro Nakano, Yusuke Kondo, Takatsugu Kajiyama, Kazuo Miyazawa, Miyo Nakano, Tomohiko Hayashi, Ryo Ito, Haruhiro Takahira, Mari Kitagawa, Yoshio Kobayashi

Erschienen in: Journal of Interventional Cardiac Electrophysiology | Ausgabe 1/2020

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Abstract

Purpose

The classification using QRS morphology of V1 lead is a useful simple predictor of accessory pathway location (type A, R or Rs pattern; type B, rS pattern; type C, QS or Qr pattern), but often leads to misdiagnosis of accessory pathway location, especially in types B and C. The synthesized 18-lead electrocardiography (ECG) derived from standard 12-lead ECG can provide virtual waveforms of right-sided chest leads. This study aimed to evaluate the usefulness of the right-sided chest lead ECG for prediction of accessory pathway location.

Methods

This retrospective study included 44 patients in whom successful ablation of manifest Wolff-Parkinson-White (WPW) syndrome was performed. Synthesized ECG waveforms were automatically generated, and ECG data obtained before the procedure.

Results

There were 26, 4, and 14 patients with left, right, and septal accessory pathways, respectively. All left accessory pathway cases have type A in V1 and syn-V4R leads. Of the 4 right accessory pathway cases, 2 have type B in V1 and syn-V4R leads. Other 2 of 4 cases have type C. In V1 lead, 5 of 14 septal accessory pathway cases have type C, 7 of 14 cases have type B, and 2 of 14cases have type A. In syn-V4R lead, all 14 septal accessory pathway cases have type C. The QRS morphology of V1 and syn-V4 leads could predict the site of accessory pathway with overall accuracy of 79% and 95%, respectively.

Conclusions

QRS morphology of syn-V4R lead may be useful for predicting accessory pathway location of manifest WPW syndrome.
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Metadaten
Titel
Estimation of the accessory pathway location of the manifest Wolf-Parkinson-White syndrome using synthesized right-sided chest leads
verfasst von
Masahiro Nakano
Yusuke Kondo
Takatsugu Kajiyama
Kazuo Miyazawa
Miyo Nakano
Tomohiko Hayashi
Ryo Ito
Haruhiro Takahira
Mari Kitagawa
Yoshio Kobayashi
Publikationsdatum
15.11.2019
Verlag
Springer US
Erschienen in
Journal of Interventional Cardiac Electrophysiology / Ausgabe 1/2020
Print ISSN: 1383-875X
Elektronische ISSN: 1572-8595
DOI
https://doi.org/10.1007/s10840-019-00648-2

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