Abstract 11125: A Novel Algorithm to Distinguish Left-sided Posteroseptal Accessory Pathway and Right-sided Posteroseptal Accessory Pathway Using the Difference in the Beginning of the Delta Wave.
Objectives: The purpose of this study is to investigate an algorithm in the prediction of successful radiofrequency (RF) catheter ablation site of the posteroseptal accessory pathway (PSAP) in manifest Wolff-Parkinson-White (WPW) syndrome.
Background: Although some algorithm of AP locations have been proposed previously, it remains still challenging to predict the successful ablation site. This is especially true for the PSAPs because it is difficult to distinguish between left-sided and right-sided PSAPs.
Methods: Thirty-one patients undergoing ablation of manifest PS-APs were investigated in retrospective analyses. They were divided into two groups; group R: right-sided PSAP (n=23) and group L: left-sided PSAP (n=8). In addition to the conventional electrophysiological parameter, the interval time between the earliest onset of the delta wave in inferior leads and latest onset in precordial leads was defined as “delta-wave difference” in both groups. On the basis of these results, we evaluated usefulness of “delta-wave difference” for the detection of left-sided and right-sided approaches.
Results: The delta-wave difference was prolonged significantly in the group L compared with the group R (group R: 11±11msec, group L: 29±11msec, p<0.001). A cut-off value of delta-wave differences <20 msec could effectively distinguish the right sided PS-APs from the left sided PS-APs with sensitivity 95% and specificity 70%.
Conclusions: In patients with manifest WPW syndrome using PSAPs, the measurement of “delta wave difference” can be a good predictor to determine approach side for the successful ablation.
- Wolff-Parkinson-White syndrome
- Accessory connections
- Supraventricular tachycardia
- © 2010 by American Heart Association, Inc.