Distinguishing Wolff-Parkinson-White Syndrome From Fasciculoventricular Pathway Using QRS-T Angle Analysis.

IF 1.7 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Pace-Pacing and Clinical Electrophysiology Pub Date : 2024-11-27 DOI:10.1111/pace.15114

Ryo Nakagawa, Kazuhisa Sato, Yoko Yoshida, Tsugutoshi Suzuki, Yoshihide Nakamura

{"title":"Distinguishing Wolff-Parkinson-White Syndrome From Fasciculoventricular Pathway Using QRS-T Angle Analysis.","authors":"Ryo Nakagawa, Kazuhisa Sato, Yoko Yoshida, Tsugutoshi Suzuki, Yoshihide Nakamura","doi":"10.1111/pace.15114","DOIUrl":null,"url":null,"abstract":"Background: Wolff-Parkinson-White (WPW) syndrome and fasciculoventricular pathway (FVP) present electrocardiographic manifestations characterized by delta waves, differentiating these two is challenging. Specifically, WPW type B with QRS width ≤120 ms, resembles typical FVP features. Because of the presence of repolarization abnormalities in WPW syndrome, our hypothesis centered on the potential utility of the QRS-T angle for distinguishing WPW syndrome from FVP. To determine the discriminative value of the QRS-T angle for delineating WPW syndrome from FVP.Methods: We included cases of WPW syndrome treated with catheter ablation and FVP diagnosed via adenosine triphosphate administration between 2007 and 2023. We excluded cases with WPW type A, QRS width >120 ms, intermittent WPW, congenital heart disease or myocardial damage, ablation history, tachycardia, palpitations within 3 months, and WPW syndrome featuring an accessory pathway on the left lateral wall. Eventually, we identified 40 and 54 patients from the WPW and FVP groups, respectively. The QRS-T angle was compared between the WPW and FVP cohorts.Results: The QRS-T angle in the WPW group was significantly larger than in the FVP group (45.7 ± 46.3° vs. 17.8 ± 13.9°, p < 0.001). Receiver operating characteristic curve analysis with a sensitivity and specificity of 65.0% and 72.6%, respectively, demonstrated that the optimal cut-off value for the QRS-T angle was 22° for distinguishing WPW from FVP. Remarkably, all cases with a QRS-T angle >65° were within the WPW group.Conclusions: The QRS-T angle can offer promising utility in differentiating WPW syndrome from FVP.","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pace-Pacing and Clinical Electrophysiology","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1111/pace.15114","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Wolff-Parkinson-White (WPW) syndrome and fasciculoventricular pathway (FVP) present electrocardiographic manifestations characterized by delta waves, differentiating these two is challenging. Specifically, WPW type B with QRS width ≤120 ms, resembles typical FVP features. Because of the presence of repolarization abnormalities in WPW syndrome, our hypothesis centered on the potential utility of the QRS-T angle for distinguishing WPW syndrome from FVP. To determine the discriminative value of the QRS-T angle for delineating WPW syndrome from FVP.

Methods: We included cases of WPW syndrome treated with catheter ablation and FVP diagnosed via adenosine triphosphate administration between 2007 and 2023. We excluded cases with WPW type A, QRS width >120 ms, intermittent WPW, congenital heart disease or myocardial damage, ablation history, tachycardia, palpitations within 3 months, and WPW syndrome featuring an accessory pathway on the left lateral wall. Eventually, we identified 40 and 54 patients from the WPW and FVP groups, respectively. The QRS-T angle was compared between the WPW and FVP cohorts.

Results: The QRS-T angle in the WPW group was significantly larger than in the FVP group (45.7 ± 46.3° vs. 17.8 ± 13.9°, p < 0.001). Receiver operating characteristic curve analysis with a sensitivity and specificity of 65.0% and 72.6%, respectively, demonstrated that the optimal cut-off value for the QRS-T angle was 22° for distinguishing WPW from FVP. Remarkably, all cases with a QRS-T angle >65° were within the WPW group.

Conclusions: The QRS-T angle can offer promising utility in differentiating WPW syndrome from FVP.

查看原文本刊更多论文

利用 QRS-T 角分析区分沃尔夫-帕金森-怀特综合征和筋束室通路

背景：沃尔夫-帕金森-怀特（WPW）综合征（Wolff-Parkinson-White，WPW）和室性筋丛通路（FVP）的心电图表现均以三角波为特征，区分这两种病很有难度。具体来说，QRS 宽度≤120 毫秒的 B 型 WPW 类似于典型的 FVP 特征。由于 WPW 综合征中存在再极化异常，我们的假设集中于 QRS-T 角在区分 WPW 综合征和 FVP 方面的潜在作用。目的：确定 QRS-T 角在区分 WPW 综合征和 FVP 方面的鉴别价值：我们纳入了 2007 年至 2023 年期间通过导管消融治疗的 WPW 综合征病例和通过三磷酸腺苷给药诊断的 FVP 病例。我们排除了 A 型 WPW、QRS 宽度大于 120 毫秒、间歇性 WPW、先天性心脏病或心肌损伤、消融史、心动过速、3 个月内心悸以及左侧壁有辅助通路的 WPW 综合征病例。最终，我们在 WPW 组和 FVP 组中分别确定了 40 名和 54 名患者。我们对 WPW 组和 FVP 组的 QRS-T 角进行了比较：结果：WPW 组的 QRS-T 角明显大于 FVP 组（45.7 ± 46.3° vs. 17.8 ± 13.9°，p < 0.001）。接收者操作特征曲线分析的灵敏度和特异度分别为 65.0% 和 72.6%，表明 QRS-T 角的最佳临界值为 22°，可用于区分 WPW 和 FVP。值得注意的是，所有 QRS-T 角大于 65° 的病例都属于 WPW 组：结论：QRS-T 角度在区分 WPW 综合征和 FVP 方面具有重要作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Pace-Pacing and Clinical Electrophysiology 医学-工程：生物医学

CiteScore

2.70

自引率

5.60%

发文量

209

审稿时长

2-4 weeks

期刊介绍： Pacing and Clinical Electrophysiology (PACE) is the foremost peer-reviewed journal in the field of pacing and implantable cardioversion defibrillation, publishing over 50% of all English language articles in its field, featuring original, review, and didactic papers, and case reports related to daily practice. Articles also include editorials, book reviews, Musings on humane topics relevant to medical practice, electrophysiology (EP) rounds, device rounds, and information concerning the quality of devices used in the practice of the specialty.