{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T11:26:10Z","timestamp":1740137170766,"version":"3.37.3"},"reference-count":7,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,2,28]],"date-time":"2022-02-28T00:00:00Z","timestamp":1646006400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Localization of atrioventricular accessory pathways (AP) from Electrocardiogram (ECG) is crucial for successful ablation. We analyzed the value of limb lead 2 versus 3 QRS vector discordance on surface ECG among right\u2010sided pathways.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from consecutive patients undergoing successful ablation of manifest AP were analyzed. They were categorized into two\u00a0groups\u2014Gr I: Endocardial ablation from anterior and anterolateral tricuspid annulus (TA, 10\u22121 o'clock, right anterolateral [RAL]); Gr II: Ablation outside this region (1\u221210 o'clock of TA). Inferior lead discordance (ILD) was defined as positive QRS complex (monophasic R, Rs) in lead 2 with negative\/equiphasic QRS vector in lead 3 (rS, S, RS). Maximally pre\u2010excited ECGs during electrophysiology study were compared for presence of ILD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>Among total 22 cases (Age 36\u2009\u00b1\u200918 years, 12 males), ILD was noted in 4\/4 cases of Gr I. It was absent among 17\/18 cases of right\u2010sided AP\u00a0in Gr II. The only case in Gr II having ILD was ablated near 8 o'clock (posterolateral). In contrast to the other four\u00a0cases, aVF was negative, along with lead 3. A close differential was mid\u2010septal AP (MSAP). However, the MSAP had\u00a0absence of r in V1 and lead 2 having rS\/RS complex in contrast to strongly positive QRS in RAL pathways. The sensitivity and specificity of ILD for RAL are 100% and 95%, respectively. The positive, negative predictive value, and accuracy are 80%, 100%, and 95%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Positive QRS complex in lead 2 with negative QRS in lead 3 in maximally pre\u2010excited ECG is often predictive of anterior and anterolateral location among right\u2010sided pathways.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15418","type":"journal-article","created":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T14:24:25Z","timestamp":1645107865000},"page":"953-961","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Positive QRS complex in limb lead 2 with negative QRS in lead 3 on surface electrocardiogram: A novel predictor for anterior location of right\u2010sided accessory pathways (10\u22121 o'clock on tricuspid annulus)"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5911-4457","authenticated-orcid":false,"given":"Debabrata","family":"Bera","sequence":"first","affiliation":[{"name":"Department of Cardiology Rabindranath Tagore International Institute of Cardiac Sciences (RTIICS)  Kolkata West Bengal India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjeev S.","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"Department of Cardiology Medica Superspeciality  Kolkata West Bengal India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4741-6241","authenticated-orcid":false,"given":"Suchit","family":"Majumder","sequence":"additional","affiliation":[{"name":"Department of Cardiology Apollo Gleneagles Hospital  Kolkata West Bengal India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunandan","family":"Sikdar","sequence":"additional","affiliation":[{"name":"Department of Cardiology Narayana Multispecialty  Kolkata West Bengal India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koushik","family":"Dasgupta","sequence":"additional","affiliation":[{"name":"Department of Cardiology Rabindranath Tagore International Institute of Cardiac Sciences (RTIICS)  Kolkata West Bengal India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayan","family":"Kar","sequence":"additional","affiliation":[{"name":"Department of Cardiology Rabindranath Tagore International Institute of Cardiac Sciences (RTIICS)  Kolkata West Bengal India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjeev","family":"Kathuria","sequence":"additional","affiliation":[{"name":"Department of Cardiology GB Pant Hospital  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5687-5007","authenticated-orcid":false,"given":"Rakesh","family":"Sarkar","sequence":"additional","affiliation":[{"name":"Medanta The Medicity  Gurugram New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,2,28]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.1998.tb00861.x"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-0736(96)80093-8"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.1996.tb03266.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(93)90296-O"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(92)90381-V"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joa.2013.10.006"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(94)90508-8"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.15418","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jce.15418","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.15418","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T02:51:28Z","timestamp":1692845488000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.15418"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,28]]},"references-count":7,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1111\/jce.15418"],"URL":"https:\/\/doi.org\/10.1111\/jce.15418","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"type":"print","value":"1045-3873"},{"type":"electronic","value":"1540-8167"}],"subject":[],"published":{"date-parts":[[2022,2,28]]},"assertion":[{"value":"2021-10-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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