Background: Predicting an accessory pathway location is extremely important in pediatric patients. Aims: We designed a study to compare previously published algorithms by Arruda, Boersma, and Chiang. Methods: This multicenter study included patients who had undergone successful ablation of one accessory pathway. Analysis of resting 12-lead electrocardiograms was carried out. An aggregated prediction score was constructed on the basis of algorithm agreement, and a structured workflow approach was proposed. Results: The total population was 120 patients (mean age, 12.7 [± 3.6] years). The algorithm by Boersma had the highest accuracy (71.7%). The inter-rater agreement among the 3 reference algorithms, according to left-sided accessory pathway (AP) identification, was good between Boersma and Chiang (κ = 0.611; 95% confidence interval [CI], 0.468–0.753) but moderate between Arruda and Chiang and between Arruda and Boersma (κ = 0.566; 95% CI, 0.419–0.713 and κ = 0.582; 95% CI, 0.438–0.727, respectively). Regarding locations at risk of atrioventricular (AV) block, agreement was fair between Arruda and Chiang and between Boersma and Chiang (κ = 0.358; 95% CI, 0.195–0.520 and κ = 0.307; 95% CI, 0.192–0.422, respectively) but moderate between Arruda and Boersma (κ = 0.45; 95% CI, 0.304–0.597). On applying a first-step diagnostic evaluation, when concordance was achieved, we were able to correctly identify left-sided or non-left-sided ablation sites in 96.4% (n = 80) of cases. When concordance was achieved, correct prediction of risk/no risk of AV block was achieved in 92.2% (n = 59) of cases. Conclusions: An aggregated prediction score based on 3 reference algorithms proved able to predict an accessory pathway location very precisely and could be used to plan safely invasive procedures.

Ferrari, P., Malanchini, G., Racheli, M., Ferrari, G., Leidi, C., Senni, M., et al. (2022). Can we improve the accuracy of electrocardiographic algorithms for accessory pathway location in children?. KARDIOLOGIA POLSKA, 80(1), 33-40 [10.33963/KP.a2021.0167].

Can we improve the accuracy of electrocardiographic algorithms for accessory pathway location in children?

Senni M.;
2022

Abstract

Background: Predicting an accessory pathway location is extremely important in pediatric patients. Aims: We designed a study to compare previously published algorithms by Arruda, Boersma, and Chiang. Methods: This multicenter study included patients who had undergone successful ablation of one accessory pathway. Analysis of resting 12-lead electrocardiograms was carried out. An aggregated prediction score was constructed on the basis of algorithm agreement, and a structured workflow approach was proposed. Results: The total population was 120 patients (mean age, 12.7 [± 3.6] years). The algorithm by Boersma had the highest accuracy (71.7%). The inter-rater agreement among the 3 reference algorithms, according to left-sided accessory pathway (AP) identification, was good between Boersma and Chiang (κ = 0.611; 95% confidence interval [CI], 0.468–0.753) but moderate between Arruda and Chiang and between Arruda and Boersma (κ = 0.566; 95% CI, 0.419–0.713 and κ = 0.582; 95% CI, 0.438–0.727, respectively). Regarding locations at risk of atrioventricular (AV) block, agreement was fair between Arruda and Chiang and between Boersma and Chiang (κ = 0.358; 95% CI, 0.195–0.520 and κ = 0.307; 95% CI, 0.192–0.422, respectively) but moderate between Arruda and Boersma (κ = 0.45; 95% CI, 0.304–0.597). On applying a first-step diagnostic evaluation, when concordance was achieved, we were able to correctly identify left-sided or non-left-sided ablation sites in 96.4% (n = 80) of cases. When concordance was achieved, correct prediction of risk/no risk of AV block was achieved in 92.2% (n = 59) of cases. Conclusions: An aggregated prediction score based on 3 reference algorithms proved able to predict an accessory pathway location very precisely and could be used to plan safely invasive procedures.
Articolo in rivista - Articolo scientifico
Algorithm; Children; Pediatric; Pre-excitation; WPW;
English
33
40
8
Ferrari, P., Malanchini, G., Racheli, M., Ferrari, G., Leidi, C., Senni, M., et al. (2022). Can we improve the accuracy of electrocardiographic algorithms for accessory pathway location in children?. KARDIOLOGIA POLSKA, 80(1), 33-40 [10.33963/KP.a2021.0167].
Ferrari, P; Malanchini, G; Racheli, M; Ferrari, G; Leidi, C; Senni, M; Bella, P; Malacrida, M; Gulletta, S; De Filippo, P
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/373457
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