Accuracy and Limitations of Published Algorithms Using the Twelve‐Lead Electrocardiogram to Localize Overt Atrioventricular Accessory Pathways
Identifieur interne : 003E46 ( Main/Exploration ); précédent : 003E45; suivant : 003E47Accuracy and Limitations of Published Algorithms Using the Twelve‐Lead Electrocardiogram to Localize Overt Atrioventricular Accessory Pathways
Auteurs : Tarek Basiouny [France] ; Christian De Chillou [France] ; Samir Fareh [France] ; Gilbert Kirkorian [France] ; Marc Messier [France] ; Nicolas Sadoul [France] ; Phillipe Chevalier [France] ; Isabelle Magnin-Poull [France] ; Ivan Blankoff [France] ; Jian Chen [France] ; Paul Touboul [France] ; Etienne Aliot [France]Source :
- Journal of Cardiovascular Electrophysiology [ 1045-3873 ] ; 1999-10.
English descriptors
- KwdEn :
- Adolescent, Adult, Algorithms, Catheter Ablation, Electrocardiography, Humans, MEDLINE, Middle Aged, Wolff-Parkinson-White Syndrome (physiopathology), Wolff-Parkinson-White Syndrome (therapy), Wolff‐Parkinson‐White syndrome, accessory pathway, algorithm, electrocardiography, radiofrequency catheter ablation.
- MESH :
- physiopathology : Wolff-Parkinson-White Syndrome.
- therapy : Wolff-Parkinson-White Syndrome.
- Adolescent, Adult, Algorithms, Catheter Ablation, Electrocardiography, Humans, MEDLINE, Middle Aged.
Abstract
Accessory Pathway Localization. Introduction: The purpose of this study was to evaluate the accuracy and limitations of published algorithms using the 12‐lead ECG to localize AV accessary pathways (APs). Methods and Results: The 11 relevant algorithms found in the literature (MEDLINE database and major scientific sessions) were tested on a series of 266 consecutive patients who successfully underwent radiofrequency catheter ablation of a single overt AV AP. The positive predictive values (PPV) of the algorithms in applicable patients were significantly lower for algorithms with > 6 accessory location sites (40.6%± 10.9% vs 61.2%± 8.0%; P < 0.03) and show a tendency for algorithms not relying on delta wave polarity but on QRS polarity only (36.6%± 11.2% vs 52.3%± 13.1%; P = 0.09). The PPV in applicable patients is related to the AP location (P < 0.001) and ranked from the highest to the lowest as follows: left lateral (mean PPV = 86.3%), posteroseptal (mean PPV = 65.2%), right anteroseptal (mean PPV = 45.2%), and right posterolateral (mean PPV = 23.4%). Conclusion: Our study suggests that the accuracy of algorithms relying on the 12‐lead ECG depends on AP locations as defined in the algorithms and on the number of AP sites. The accuracy tends to be lower when delta wave polarity is not included in the algorithm's architecture. This should be considered when using these algorithms or when building new ones.
Url:
DOI: 10.1111/j.1540-8167.1999.tb00189.x
Affiliations:
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Phillipe" sort="Chevalier, Phillipe" uniqKey="Chevalier P" first="Phillipe" last="Chevalier">Phillipe Chevalier</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Hôpital Cardio‐Vasculaire et Pneumologique Louis Pradel, Lyon</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Lyon</settlement></placeName></affiliation></author><author><name sortKey="Magnin Oull, Isabelle" sort="Magnin Oull, Isabelle" uniqKey="Magnin Oull I" first="Isabelle" last="Magnin-Poull">Isabelle Magnin-Poull</name><affiliation wicri:level="3"><country>France</country><placeName><settlement type="city">Nancy</settlement><region type="region" nuts="2">Grand Est</region><region type="old region" nuts="2">Lorraine (région)</region></placeName><wicri:orgArea>Service de Cardiologic, Hôpital Central</wicri:orgArea></affiliation></author><author><name sortKey="Blankoff, Ivan" sort="Blankoff, Ivan" uniqKey="Blankoff I" first="Ivan" last="Blankoff">Ivan Blankoff</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Hôpital Cardio‐Vasculaire et Pneumologique Louis Pradel, Lyon</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Lyon</settlement></placeName></affiliation></author><author><name sortKey="Chen, Jian" sort="Chen, Jian" uniqKey="Chen J" first="Jian" last="Chen">Jian Chen</name><affiliation wicri:level="3"><country>France</country><placeName><settlement type="city">Nancy</settlement><region type="region" nuts="2">Grand Est</region><region type="old region" nuts="2">Lorraine (région)</region></placeName><wicri:orgArea>Service de Cardiologic, Hôpital Central</wicri:orgArea></affiliation></author><author><name sortKey="Touboul, Paul" sort="Touboul, Paul" uniqKey="Touboul P" first="Paul" last="Touboul">Paul Touboul</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Hôpital Cardio‐Vasculaire et Pneumologique Louis Pradel, Lyon</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Lyon</settlement></placeName></affiliation></author><author><name sortKey="Aliot, Etienne" sort="Aliot, Etienne" uniqKey="Aliot E" first="Etienne" last="Aliot">Etienne Aliot</name><affiliation wicri:level="3"><country>France</country><placeName><settlement type="city">Nancy</settlement><region type="region" nuts="2">Grand Est</region><region type="old region" nuts="2">Lorraine (région)</region></placeName><wicri:orgArea>Service de Cardiologic, Hôpital Central</wicri:orgArea></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Cardiovascular Electrophysiology</title><idno type="ISSN">1045-3873</idno><idno type="eISSN">1540-8167</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="1999-10">1999-10</date><biblScope unit="volume">10</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="1340">1340</biblScope><biblScope unit="page" to="1349">1349</biblScope></imprint><idno type="ISSN">1045-3873</idno></series><idno type="istex">A79DF12C78D67E586395E54BAB324418E2DE7FB0</idno><idno type="DOI">10.1111/j.1540-8167.1999.tb00189.x</idno><idno type="ArticleID">JCE1340</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1045-3873</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Algorithms</term><term>Catheter Ablation</term><term>Electrocardiography</term><term>Humans</term><term>MEDLINE</term><term>Middle Aged</term><term>Wolff-Parkinson-White Syndrome (physiopathology)</term><term>Wolff-Parkinson-White Syndrome (therapy)</term><term>Wolff‐Parkinson‐White syndrome</term><term>accessory pathway</term><term>algorithm</term><term>electrocardiography</term><term>radiofrequency catheter ablation</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Wolff-Parkinson-White Syndrome</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Wolff-Parkinson-White Syndrome</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Algorithms</term><term>Catheter Ablation</term><term>Electrocardiography</term><term>Humans</term><term>MEDLINE</term><term>Middle Aged</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Accessory Pathway Localization. Introduction: The purpose of this study was to evaluate the accuracy and limitations of published algorithms using the 12‐lead ECG to localize AV accessary pathways (APs). Methods and Results: The 11 relevant algorithms found in the literature (MEDLINE database and major scientific sessions) were tested on a series of 266 consecutive patients who successfully underwent radiofrequency catheter ablation of a single overt AV AP. The positive predictive values (PPV) of the algorithms in applicable patients were significantly lower for algorithms with > 6 accessory location sites (40.6%± 10.9% vs 61.2%± 8.0%; P < 0.03) and show a tendency for algorithms not relying on delta wave polarity but on QRS polarity only (36.6%± 11.2% vs 52.3%± 13.1%; P = 0.09). The PPV in applicable patients is related to the AP location (P < 0.001) and ranked from the highest to the lowest as follows: left lateral (mean PPV = 86.3%), posteroseptal (mean PPV = 65.2%), right anteroseptal (mean PPV = 45.2%), and right posterolateral (mean PPV = 23.4%). Conclusion: Our study suggests that the accuracy of algorithms relying on the 12‐lead ECG depends on AP locations as defined in the algorithms and on the number of AP sites. The accuracy tends to be lower when delta wave polarity is not included in the algorithm's architecture. This should be considered when using these algorithms or when building new ones.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Auvergne-Rhône-Alpes</li><li>Grand Est</li><li>Lorraine (région)</li><li>Rhône-Alpes</li></region><settlement><li>Lyon</li><li>Nancy</li></settlement></list><tree><country name="France"><region name="Grand Est"><name sortKey="Basiouny, Tarek" sort="Basiouny, Tarek" uniqKey="Basiouny T" first="Tarek" last="Basiouny">Tarek Basiouny</name></region><name sortKey="Aliot, Etienne" sort="Aliot, Etienne" uniqKey="Aliot E" first="Etienne" last="Aliot">Etienne Aliot</name><name sortKey="Blankoff, Ivan" sort="Blankoff, Ivan" uniqKey="Blankoff I" first="Ivan" last="Blankoff">Ivan Blankoff</name><name sortKey="Chen, Jian" sort="Chen, Jian" uniqKey="Chen J" first="Jian" last="Chen">Jian Chen</name><name sortKey="Chevalier, Phillipe" sort="Chevalier, Phillipe" uniqKey="Chevalier P" first="Phillipe" last="Chevalier">Phillipe Chevalier</name><name sortKey="De Chillou, Christian" sort="De Chillou, Christian" uniqKey="De Chillou C" first="Christian" last="De Chillou">Christian De Chillou</name><name sortKey="De Chillou, Christian" sort="De Chillou, Christian" uniqKey="De Chillou C" first="Christian" last="De Chillou">Christian De Chillou</name><name sortKey="Fareh, Samir" sort="Fareh, Samir" uniqKey="Fareh S" first="Samir" last="Fareh">Samir Fareh</name><name sortKey="Kirkorian, Gilbert" sort="Kirkorian, Gilbert" uniqKey="Kirkorian G" first="Gilbert" last="Kirkorian">Gilbert Kirkorian</name><name sortKey="Magnin Oull, Isabelle" sort="Magnin Oull, Isabelle" uniqKey="Magnin Oull I" first="Isabelle" last="Magnin-Poull">Isabelle Magnin-Poull</name><name sortKey="Messier, Marc" sort="Messier, Marc" uniqKey="Messier M" first="Marc" last="Messier">Marc Messier</name><name sortKey="Sadoul, Nicolas" sort="Sadoul, Nicolas" uniqKey="Sadoul N" first="Nicolas" last="Sadoul">Nicolas Sadoul</name><name sortKey="Touboul, Paul" sort="Touboul, Paul" uniqKey="Touboul P" first="Paul" last="Touboul">Paul Touboul</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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