What Are the Accuracy and Limitations of Published Algorithms Using Surface ECG to Localize Overt AV Accessory Pathways

Pre-excitation produces an anomalous ventricular activation through pathways other than His bundle, and so ventricular complexes observed in Wolff-Parkinson-White (WPW) syndrome during periods of sinoatrial rhythm are the results of fusion: the first phase of ventricular activation consists of excitation via the accessory pathway, while later forces result from the depolarization of residual portions of the ventricles via the His-Purkinje system [1–3].

[1]  J. L. Willems,et al.  Criteria for intraventricular conduction disturbances and pre-excitation. World Health Organizational/International Society and Federation for Cardiology Task Force Ad Hoc. , 1985, Journal of the American College of Cardiology.

[2]  J. Gallagher.  Wolff‐Parkinson‐White Syndrome: Surgery to Radiofrequency Catheter Ablation , 1997, Pacing and clinical electrophysiology : PACE.

[3]  C. Tai,et al.  An accurate stepwise electrocardiographic algorithm for localization of accessory pathways in patients with Wolff-Parkinson-White syndrome from a comprehensive analysis of delta waves and R/S ratio during sinus rhythm. , 1995, The American journal of cardiology.

[4]  B. Lindsay,et al.  Concordance of distinguishing electrocardiographic features during sinus rhythm with the location of accessory pathways in the Wolff-Parkinson-White syndrome. , 1987, The American journal of cardiology.

[5]  L. Schamroth,et al.  The localization of bypass tracts in the Wolff-Parkinson-White syndrome from the surface electrocardiogram. , 1987, American heart journal.

[6]  C. Chiang,et al.  Incidence, significance, and pharmacological responses of catheter-induced mechanical trauma in patients receiving radiofrequency ablation for supraventricular tachycardia. , 1994, Circulation.

[7]  W C Sealy,et al.  The preexcitation syndromes. , 1978, Progress in cardiovascular diseases.

[8]  A. Tonkin,et al.  Initial Forces of Ventricular Depolarization in the Wolff-Parkinson-White Syndrome: Analysis Based upon Localization of the Accessory Pathway by Epicardial Mapping , 1975, Circulation.

[9]  L. Widman,et al.  Development and Validation of an ECG Algorithm for Identifying Accessory Pathway Ablation Site in Wolff‐Parkinson‐White Syndrome , 1998, Journal of cardiovascular electrophysiology.

[10]  J. Gallagher,et al.  Wolff-Parkinson-White syndrome. The problem, evaluation, and surgical correction. , 1975, Circulation.

[11]  H. Wellens,et al.  Recurrence rate after accessory pathway ablation. , 1994, British heart journal.

[12]  Arjun D. Sharma,et al.  An Algorithm for the Electrocardiographic Localization of Accessory Pathways in the Wolff‐Parkinson‐White Syndrome , 1987, Pacing and clinical electrophysiology : PACE.

[13]  J. Spear,et al.  Basis of static and dynamic electrocardiographic variations in Wolff-Parkinson-White syndrome. Anatomic and electrophysiologic observations in right and left ventricular preexcitation. , 1973, The American journal of cardiology.

[14]  T. Walsh,et al.  WOLFF-PARKINSON-WHITE SYNDROME. , 1965, American heart journal.

[15]  A. Camm,et al.  Localization of accessory pathways from the 12-lead electrocardiogram using a new algorithm. , 1994, The American journal of cardiology.

[16]  G. V. Van Hare,et al.  Electrocardiographic and electrophysiologic characteristics of anterior, midseptal and right anterior free wall accessory pathways. , 1992, Journal of the American College of Cardiology.

[17]  A. Camm,et al.  Radiofrequency ablation of accessory atrioventricular pathways: predictive value of local electrogram characteristics for the identification of successful target sites. , 1993, British heart journal.