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EPM algorithm: a stepwise approach to accessory pathway localization in ventricular pre-excitation
de Alencar Neto, José Nunes; Sakai, Marcel Henrique; de Almeida Neto, Rogério Gomes; Scheffer, Matheus Kiszka; Alencar E Silva, Gabriel Pinheiro Soares; Cirenza, Claudio; de Paola, Angelo Amato Vincenzo.
Afiliação
  • de Alencar Neto, José Nunes; Instituto Dante Pazzanese de Cardiologia. Hospital São Paulo. São Paulo. BR
  • Sakai, Marcel Henrique; Universidade Federal de São Paulo. Hospital São Paulo. São Paulo. BR
  • de Almeida Neto, Rogério Gomes; Universidade Federal de São Paulo. Hospital São Paulo. São Paulo. BR
  • Scheffer, Matheus Kiszka; Instituto Dante Pazzanese de Cardiologia. São Paulo. BR
  • Alencar E Silva, Gabriel Pinheiro Soares; Hospital Ernesto Dornelles. Rio Grande do Sul. BR
  • Cirenza, Claudio; Universidade Federal de São Paulo. Hospital São Paulo. São Paulo. BR
  • de Paola, Angelo Amato Vincenzo; Universidade Federal de São Paulo. Hospital São Paulo. São Paulo. BR
J. eletrocardiol ; 84: 1-8, fev.2024. graf
Article em En | CONASS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1532550
Biblioteca responsável: BR79.1
ABSTRACT

BACKGROUND:

Accurate estimation of accessory pathway (AP) localization in patients with ventricular pre-excitation or Wolff-Parkinson-White (WPW) syndrome remains a diagnostic challenge. Existing algorithms have contributed significantly to this area, but alternative algorithms can offer additional perspectives and approaches to AP localization.

OBJECTIVE:

This study introduces and evaluates the diagnostic accuracy of the EPM algorithm in AP localization, comparing it with established algorithms Arruda and EASY.

METHODS:

A retrospective analysis was conducted on 138 patients from Hospital São Paulo who underwent catheter ablation. Three blinded examiners assessed the EPM algorithm's diagnostic accuracy against the Arruda and EASY algorithms. The gold standard for comparison was the radioscopic position of the AP where radiofrequency ablation led to pre-excitation disappearance on the ECG.

RESULTS:

EPM showed a diagnostic accuracy of 51.45%, closely aligning with Arruda (53.29%) and EASY (44.69%). Adjacency accuracy for EPM was 70.67%, with Arruda at 66.18% and EASY at 72.22%. Sensitivity for EPM in distinguishing left vs. right APs was 95.73%, with a specificity of 74.33%. For identifying septal vs. lateral right APs, EPM sensitivity was 82.79% with a specificity of 46.15%. These measures were comparable to those of Arruda and EASY. Inter-observer variability was excellent for EPM, with Kappa statistics over 0.9.

CONCLUSION:

The EPM algorithm emerges as a reliable tool for AP localization, offering a systematic approach beneficial for therapeutic decision-making in electrophysiology. Its comparable diagnostic accuracy and excellent inter-observer variability underscore its potential clinical applicability. Future research may further validate its efficacy in a broader clinical setting.
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Texto completo: 1 Coleções: 06-national / BR Base de dados: CONASS / SES-SP / SESSP-IDPCPROD Assunto principal: Síndrome de Wolff-Parkinson-White / Eletrofisiologia Idioma: En Revista: J. eletrocardiol Ano de publicação: 2024 Tipo de documento: Article
Texto completo
Adicionar na Minha BVS
Imprimir
XML
Buscar no Google

Texto completo: 1 Coleções: 06-national / BR Base de dados: CONASS / SES-SP / SESSP-IDPCPROD Assunto principal: Síndrome de Wolff-Parkinson-White / Eletrofisiologia Idioma: En Revista: J. eletrocardiol Ano de publicação: 2024 Tipo de documento: Article