Localization of apparent accessory pathways using an algorithm based on surface electrocardiograms

pp 49-52

Abstract

With the advent of ablative therapies in the Wolff- Parkinson-White syndrome, the methods to localize the accesory pathways have improved greatly. However, the analysis of the electrocardiogram, which is a simple method, in patients with evident preexcitation, can provide important information to estime the localization of the accessory pathways. This data is important in the decision of adequate therapy. In this study, we evaluated the validity of a simple algorhythm. Based on the surface electrocardiogram, to predict the real localization of these pathways in the atrioventricular ring. For this purpose we analysed 39 patients who underwent successful surgical ablation, guided by intraoperative mapping. The algorhythm divided the accesory pathways in four anatomic regions, namely, left ventricular free wall, posterior wall, right ventricular free wall and anterior wall. The electrocardiograms were analysed by two observers in a blinded fashion. They were able to predict the real localization of the accessory pathways in most of the patients (92 % and 900/.). We conclude that the mentioned algorhythm provides a simple and practical first approximation of the accessory pathway localization.