TY - JOUR
T1 - Algorithm for differentiation of left and right posterior paraseptal accessory pathway
AU - Takenaka, So
AU - Yeh, San Jou
AU - Wen, Ming Shien
AU - Yeh, Kuan Hung
AU - Wang, Chun Chieh
AU - Lin, Fun Chung
AU - Wu, Delon
PY - 2004/4
Y1 - 2004/4
N2 - We studied 196 consecutive patients with posterior paraseptal accessory pathway (AP); 124 showed manifest preexcitation and 72 were concealed AP. Successful ablation was obtained from left-sided approach in 134 patients (left posterior pasaseptal [LPS] group) and from right sided approach in 62 patients (right posterior paraseptal [RPS] group). A ventriculoatrial (VA) interval of <50 ms recorded at LPS region (VALPS) during right ventricular pacing identified 95 of the 134 patients (71%) with LPS AP with 100% specificity and positive predictive value. In the 101 patients with VA LPS ≥50 ms, a difference in VA interval of <20 ms recorded at the His bundle region and LPS region, ΔVA(H-LPS), during right ventricular pacing predicted RPS AP with a sensitivity of 97%, a specificity of 85% and a positive predictive value of 91%. When these 2 parameters were used together for prediction of LPS or RPS AP, the sensitivity, specificity, and positive predictive value were 96%, 97%, and 98% for LPS AP, and 97%, 96%, and 91% for RPS AP, respectively. This simple new algorithm using VALps and ΔVA (H-LPS) during right ventricular pacing successfully discriminates LPS and RPS AP with high sensitivity, specificity, and positive predictive value and could facilitate radiofrequency ablation in patients with posterior paraseptal AP.
AB - We studied 196 consecutive patients with posterior paraseptal accessory pathway (AP); 124 showed manifest preexcitation and 72 were concealed AP. Successful ablation was obtained from left-sided approach in 134 patients (left posterior pasaseptal [LPS] group) and from right sided approach in 62 patients (right posterior paraseptal [RPS] group). A ventriculoatrial (VA) interval of <50 ms recorded at LPS region (VALPS) during right ventricular pacing identified 95 of the 134 patients (71%) with LPS AP with 100% specificity and positive predictive value. In the 101 patients with VA LPS ≥50 ms, a difference in VA interval of <20 ms recorded at the His bundle region and LPS region, ΔVA(H-LPS), during right ventricular pacing predicted RPS AP with a sensitivity of 97%, a specificity of 85% and a positive predictive value of 91%. When these 2 parameters were used together for prediction of LPS or RPS AP, the sensitivity, specificity, and positive predictive value were 96%, 97%, and 98% for LPS AP, and 97%, 96%, and 91% for RPS AP, respectively. This simple new algorithm using VALps and ΔVA (H-LPS) during right ventricular pacing successfully discriminates LPS and RPS AP with high sensitivity, specificity, and positive predictive value and could facilitate radiofrequency ablation in patients with posterior paraseptal AP.
KW - Ablation
KW - Electrophysiology
KW - Supraventricular tachycardia
UR - http://www.scopus.com/inward/record.url?scp=2442677851&partnerID=8YFLogxK
U2 - 10.1016/j.jelectrocard.2004.01.004
DO - 10.1016/j.jelectrocard.2004.01.004
M3 - 文章
C2 - 15127372
AN - SCOPUS:2442677851
SN - 0022-0736
VL - 37
SP - 75
EP - 81
JO - Journal of Electrocardiology
JF - Journal of Electrocardiology
IS - 2
ER -