Document Detail


ECG criteria for accurate localization of left anterolateral and posterolateral accessory pathways.
MedLine Citation:
PMID:  23035773     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
METHODS: The ECGs from patients who underwent ablation of a left-sided AP between 2001 and 2008 were evaluated for the relationship of QRS amplitudes in limb leads II and III. A LAL-AP was defined by successful ablation between 12 and 3 o'clock on the MA, as seen in left anterior oblique (LAO) fluoroscopic projection. A LPL-AP was defined by successful ablation between 3 and 6 o'clock in the LAO projection.
RESULTS: In 249 consecutive patients undergoing AP ablation, 23 met the prespecified inclusion criteria: manifest preexcitation due to single AP, ablated successfully in a LAL or LPL location. The ratio of dominant QRS amplitude in lead II to lead III was ≥ 1 in 10/11 patients with LAL-AP, compared with 3/12 patients with a LPL-AP (P = 0.002). Using these criteria, two blinded reviewers predicted a LAL or LPL location with 87% accuracy and 100% interobserver agreement.
CONCLUSIONS: We report new ECG criteria that can be used to accurately predict the anterior and posterior location of a left lateral AP. Such localization may facilitate procedural planning.
Authors:
Joshua D Moss; Edward P Gerstenfeld; Rajat Deo; Mathew D Hutchinson; David J Callans; Francis E Marchlinski; Sanjay Dixit
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Publication Detail:
Type:  Journal Article     Date:  2012-10-04
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  35     ISSN:  1540-8159     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-11     Completed Date:  2013-05-27     Revised Date:  2014-04-08    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1444-50     Citation Subset:  IM    
Copyright Information:
©2012, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.
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MeSH Terms
Descriptor/Qualifier:
Accessory Atrioventricular Bundle / physiopathology*,  surgery*
Algorithms
Catheter Ablation*
Electrocardiography*
Female
Fluoroscopy
Humans
Male
ROC Curve
Treatment Outcome
Wolff-Parkinson-White Syndrome / physiopathology*,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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