{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T11:26:25Z","timestamp":1740137185894,"version":"3.37.3"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T00:00:00Z","timestamp":1674086400000},"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":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Despite numerous ECG algorithms being developed to localize the site of manifest accessory pathways (AP), they often require stepwise multiple\u2010lead analysis with variable accuracy, limitations, and reproducibility. The study aimed to develop a single\u2010lead ECG algorithm incorporating the P\u2010Delta interval (PDI) as an adjunct criterion to discriminate between right and left manifest AP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive WPW patients undergoing electrophysiological study (EPS) were retrospectively recruited and split into a derivation and validation group (1:1 ratio). Sinus rhythm ECG analysis in lead V1 was performed by three independent investigators blinded to the EPS results. Conventional ECG parameters and PDI were assessed through the global cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 140 WPW patients were included (70 for each group). A score\u2010based, single\u2010lead ECG algorithm was developed through derivation analysis incorporating the PDI, R\/S ratio, and QRS onset polarity in lead V1. The validation group analysis confirmed the proposed algorithm's high accuracy (95%), which was superior to the previous ones in predicting the AP side (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). A score of \u2264+1 was 96.5% accurate in predicting right AP while a score of \u2265+2 was 92.5% accurate in predicting left AP. The new algorithm maintained optimal performance in specific subgroups of the global cohort showing an accuracy rate of 90%, 92%, and 96% in minimal pre\u2010excitation, posteroseptal AP, and pediatric patients, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A novel single\u2010lead ECG algorithm incorporating the PDI interval with previous conventional criteria showed high accuracy in differentiating right from left manifest AP comprising pediatric and minimal pre\u2010excitation subgroups in the current study.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15818","type":"journal-article","created":{"date-parts":[[2023,1,14]],"date-time":"2023-01-14T20:09:37Z","timestamp":1673726977000},"page":"598-606","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Single\u2010lead ECG algorithm to differentiate right from left manifest accessory pathways: A reappraisal of the P\u2010Delta interval"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3469-1028","authenticated-orcid":false,"given":"Hussam","family":"Ali","sequence":"first","affiliation":[{"name":"Arrhythmia &amp; Electrophysiology Center IRCCS MultiMedica Sesto San Giovanni Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmine","family":"De Lucia","sequence":"additional","affiliation":[{"name":"Arrhythmia &amp; Electrophysiology Center IRCCS MultiMedica Sesto San Giovanni Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ernesto","family":"Cristiano","sequence":"additional","affiliation":[{"name":"Arrhythmia &amp; Electrophysiology Center IRCCS MultiMedica Sesto San Giovanni Milan Italy"},{"name":"Department of Clinical and Molecular Medicine, Division of Cardiology,\u00a0St. Andrea Hospital Sapienza University Rome 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