Accessory pathway localization with probabilistic density maps generated by a mobile application: Assessment of a full pre-excitation net-vector method.

Autor: Jastrzębski M; First Department of Cardiology, Interventional Electrocardiology and Hypertension, Medical College, Jagiellonian University, Kraków, Poland., Fijorek K; Department of Statistics, Cracow University of Economics, Kraków, Poland., Futyma P; University of Rzeszów and St. Joseph's Heart Rhythm Center, Rzeszów, Poland., Orczykowski M; 1st. Arrhythmia Department, National Institute of Cardiology, Arrhythmia Center, Warsaw, Poland., Pitak M; Department of Cardiology, Institute of Paediatrics, Jagiellonian University Medical College, Kraków, Poland., Zarębski Ł; University of Rzeszów and St. Joseph's Heart Rhythm Center, Rzeszów, Poland., Sajdak P; University of Rzeszów and St. Joseph's Heart Rhythm Center, Rzeszów, Poland., Góreczny S; Department of Cardiology, Institute of Paediatrics, Jagiellonian University Medical College, Kraków, Poland., Szumowski Ł; 1st. Arrhythmia Department, National Institute of Cardiology, Arrhythmia Center, Warsaw, Poland., Rajzer M; First Department of Cardiology, Interventional Electrocardiology and Hypertension, Medical College, Jagiellonian University, Kraków, Poland., Moskal P; Electrophysiology Laboratory, University Hospital in Krakow, Krakow, Poland.
Jazyk: angličtina
Zdroj: Journal of cardiovascular electrophysiology [J Cardiovasc Electrophysiol] 2024 Jun; Vol. 35 (6), pp. 1083-1094. Date of Electronic Publication: 2024 Mar 21.
DOI: 10.1111/jce.16252
Abstrakt: Introduction: Precise electrocardiographic localization of accessory pathways (AP) can be challenging. Seminal AP localization studies were limited by complexity of algorithms and sample size. We aimed to create a nonalgorithmic method for AP localization based on color-coded maps of AP distribution generated by a web-based application.
Methods: APs were categorized into 19 regions/types based on invasive electrophysiologic mapping. Preexcited QRS complexes were categorized into 6 types based on polarity and notch/slur. For each QRS type in each lead the distribution of APs was visualized on a gradient map. The principle of common set was used to combine the single lead maps to create the distribution map for AP with any combination of QRS types in several leads. For the validation phase, a separate cohort of APs was obtained.
Results: A total of 800 patients with overt APs were studied. The application used the exploratory data set of 553 consecutive APs and the corresponding QRS complexes to generate AP localization maps for any possible combination of QRS types in 12 leads. Optimized approach (on average 3 steps) for evaluation of preexcited electrcardiogram was developed. The area of maximum probability of AP localization was pinpointed by providing the QRS type for the subsequent leads. The exploratory data set was validated with the separate cohort of APs (n = 256); p = .23 for difference in AP distribution.
Conclusions: In the largest data set of APs to-date, a novel probabilistic and semi-automatic approach to electrocardiographic localization of APs was highly predictive for anatomic localization.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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