COMPARISON OF THE ACCURACY OF THREE ALGORITHMS IN PREDICTING ACCESSORY PATHWAYS AMONG ADULT WOLFF-PARKINSON-WHITE SYNDROME PATIENTS
K. Balci, O. Maden, M. Balci, T. Selcuk, B. Acar, S. Unal, M. Kara, H. Selcuk
CARDIOLOGY, Turkiye Yuksek Ihtisas Research and Education Hospital, Ankara, Turkey
Introduction: After the introduction of catheter ablation of atrio-ventricular accessory pathways (APs) in Wolff-Parkinson-White (WPW) syndrome, in order to facilitate the planned ablation predicting the AP was required. In this study we investigated the accuracy of three algorithms in predicting AP locations in adult patients with WPW syndrome.
Methods: A total of 207 adult patients with WPW syndrome were retrospectively analysed. The most pre-excited 12-lead electrocardiogram in sinus rhythm was used for analysis.
Results: When only exact locations were accepted as match, the percentage of predictive accuracy of all algorithms did not differ between the algorithms (Chiang: 71.5%, p=1.000; d’Avila: 72.4%, p=0.875; Arruda: 71.5%, p=0.885, respectively). The best algorithm for prediction of right-sided, left-sided and anteroseptal and midseptal accessory pathways was Arruda (p<0.001). Arruda was significantly better than d’Avila in predicting adjacent sites (p=0.035) and the percent of the opposite site prediction was higher with d’Avila than Arruda (p=0.013).
Conclusions: All algorithms were similar in predicting accessory pathway location. However, according to the accessory pathway site, the algorithm designed by Arruda et al. showed better predictions than the other algorithms.
Comparison of the algorithms according to the percentage of the exact matches.
| | Arruda | p-value † |
| Mismatch | Match | Total |
| d’Avila | | | | 0.875 |
| Match | 38 (18.4%) | 19 (9.2%) | 57 (27.6%) | |
| Mismatch | 21 (10.1%) | 129 (62.3%) | 150 (72.4%) | |
| Total | 59 (28.5%) | 148 (71.5%) | 207 (100%) | |
| | Arruda | p-value † |
| Mismatch | Match | Total |
| Chiang | | | | 1.000 |
| Match | 38 (18.4%) | 21 (10.1%) | 59 (28.5%) | |
| Mismatch | 21 (10.1%) | 127 (61.4%) | 148 (71.5%) | |
| Total | 59 (28.5%) | 148 (71.5%) | 207 (100%) | |
| | d’Avila | p-value † |
| Mismatch | Match | Total |
| Chiang | | | | 0.885 |
| Match | 34 (16.4%) | 25 (12.1%) | 59 (28.5%) | |
| Mismatch | 23 (11.2%) | 125 (60.3%) | 148 (71.5%) | |
| Total | 57 (27.6%) | 150 (72.4%) | 207 (100%) | |
Comparison of the predictive accuracy of three algorithms according to the site of the accessory pathway.
| | Odds ratio | %95 confidence interval | Wald | p-value |
| Lower | Upper |
| Left-sided | | | | | |
| Arruda | 79.693 | 11.987 | 529.832 | 20.519 | <0.001 |
| d’Avila | 3.305 | 0.570 | 19.170 | 1.776 | 0.183 |
| Chiang | 17.979 | 3.536 | 91.427 | 12.123 | <0.001 |
| Right-sided | | | | | |
| Arruda | 73.994 | 17.959 | 304.874 | 35.495 | <0.001 |
| d‘Avila | 0.969 | 0.232 | 4.047 | 0.002 | 0.966 |
| Chiang | 15.155 | 3.877 | 59.239 | 15.274 | <0.001 |
| Midseptal/anteroseptal | | | | | |
| Arruda | 56.159 | 8.043 | 392.143 | 16.504 | <0.001 |
| d‘Avila | 31.278 | 4.241 | 230.665 | 11.406 | <0.001 |
| Chiang | 0.471 | 0.036 | 6.244 | 0.325 | 0.568 |
