V1r+DIIq is a novel and accurate criterion to predict right vs. left paraseptal accessory pathways

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dc.contributor.authorSahin, Durmus Yildiray
dc.contributor.authorKaypakli, Onur
dc.contributor.authorArdic, Mustafa Lutfullah
dc.contributor.authorMarangozoglu, Yusuf
dc.contributor.authorKoca, Hasan
dc.date.accessioned2024-09-18T21:00:31Z
dc.date.available2024-09-18T21:00:31Z
dc.date.issued2022
dc.departmentHatay Mustafa Kemal Üniversitesien_US
dc.description.abstractPurpose: The correct estimation of accessory pathway (AP) localization from surface ECG is critical before the procedure. Our study aimed to detect the predictive value of the V1r + DIIq criterion for differentiating right-from left-sided paraseptal APs. Methods: We retrospectively included 58 patients with (Wolff-Parkinson-White) WPW syndrome and paraseptal APs who underwent successful catheter ablation (37 male, 21 female; mean age 34.4 +/- 13.6 years). The V1r + DIIq criterion was calculated using the following formula: V1r + DIIq (mV) = initial r wave amplitude in V1 + q wave amplitude in DII. The combined criterion included V1r + DIIq <2.05 mV and/or no initial r wave in V1. Results: Right-sided paraseptal APs were detected in 36 patients (62.1%), left-sided paraseptal APs were detected in 21 patients (36.2%), and AP from CS was detected in 1 patient (1.7%). The initial r wave amplitude in V1 (mV), q wave amplitude in DII (mV) and V1r + DIIq criterion (mV) were lower in patients with right-sided paraseptal APs (p < 0.001). The percentage of patients with no initial r wave in V1 (36.1% vs. 0%) and those meeting the combined criterion (91.7% vs. 4.5%) were increased in patients with right-sided paraseptal APs. The cutoff value of the V1r + DIIq criterion obtained by ROC curve analysis was 2.05 mV for predicting right-sided paraseptal APs (sensitivity: 86.1%, specificity: 95.5%). The area under the curve (AUC) was 0.943 (95% CI = 0.881-1.000) (p < 0.001). The sensitivity and specificity values were 36.1% and 100%, respectively, for the no initial r wave criterion and 91.7% and 95.5%, respectively, for the combined criterion. Conclusion: The V1r + DIIq criterion and the combined criterion represent novel and simple electrocardiographic criteria for accurately differentiating right-from left-sided paraseptal APs. This simple ECG measurement can improve the accuracy of detection of paraseptal AP localization and could be beneficial for decreasing ablation duration and radiation exposure. (c) 2021 Elsevier Inc. All rights reserved.en_US
dc.identifier.doi10.1016/j.jelectrocard.2021.11.028
dc.identifier.endpage34en_US
dc.identifier.issn0022-0736
dc.identifier.issn1532-8430
dc.identifier.pmid34844144en_US
dc.identifier.scopus2-s2.0-85119906627en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.startpage30en_US
dc.identifier.urihttps://doi.org/10.1016/j.jelectrocard.2021.11.028
dc.identifier.urihttps://hdl.handle.net/20.500.12483/12732
dc.identifier.volume70en_US
dc.identifier.wosWOS:000746079700008en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherChurchill Livingstone Inc Medical Publishersen_US
dc.relation.ispartofJournal of Electrocardiologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectV1r+DIIq criterionen_US
dc.subjectParaseptal accessory pathwaysen_US
dc.subjectRadiofrequency ablationen_US
dc.titleV1r+DIIq is a novel and accurate criterion to predict right vs. left paraseptal accessory pathwaysen_US
dc.typeArticleen_US

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