{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T10:29:24Z","timestamp":1786444164421,"version":"build-2736575974"},"reference-count":43,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In Wolff\u2013Parkinson\u2013White (WPW) syndrome, accurate localization of accessory pathways before catheter ablation can improve procedural planning and efficiency. Several 12\u2010lead electrocardiographic (ECG) algorithms have been proposed, but their diagnostic performance has not been consistently established. We performed a systematic review and meta\u2010analysis to assess the accuracy of ECG\u2010based algorithms for accessory pathway localization in manifest WPW.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following PRISMA\u2010DTA recommendations, PubMed, EMBASE, Cochrane CENTRAL, Web of Science, and Scopus were searched from January 1990 to January 2026. Studies enrolling adult or pediatric patients with manifest pre\u2010excitation who underwent electrophysiological study (EPS) and catheter ablation were included. Successful localization during EPS\/ablation served as the reference standard. Random\u2010effects models were used to calculate pooled diagnostic accuracy, sensitivity, specificity, and diagnostic odds ratios (DOR). Summary receiver operating characteristic and leave\u2010one\u2010out sensitivity analyses were also performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventeen studies involving 3159 patients met inclusion criteria. The pooled diagnostic accuracy of ECG algorithms was 0.91 (95% CI 0.85\u20130.94), although heterogeneity was substantial (I\n                      <jats:sup>2<\/jats:sup>\n                      = 91.4%). Pooled sensitivity was 0.87 (95% CI 0.73\u20130.94), and pooled specificity was 0.98 (95% CI 0.95\u20130.99; I\n                      <jats:sup>2<\/jats:sup>\n                      = 0%). The pooled DOR was 297.17 (95% CI 46.33\u20131906.19;\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.0001). Sensitivity analyses showed stable results after sequential exclusion of individual studies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Twelve\u2010lead ECG algorithms provide high diagnostic performance for accessory pathway localization in manifest WPW and may be useful adjuncts for pre\u2010ablation planning, although invasive electrophysiological mapping remains essential.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pace.70387","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T09:35:31Z","timestamp":1786440931000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Accuracy of 12\u2010Lead ECG Algorithms for Accessory Pathway Localization in WPW: A Meta\u2010Analysis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6178-8183","authenticated-orcid":false,"given":"Elsayed S.","family":"Moubarak","sequence":"first","affiliation":[{"name":"Faculty of Medicine Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5802-2291","authenticated-orcid":false,"given":"Ahmed Farid","family":"Gadelmawla","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Menoufia University  Menoufia Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6266-4991","authenticated-orcid":false,"given":"Almothana","family":"Manasrah","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine United Health Services\u2014Wilson Medical Center  Johnson City New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9111-320X","authenticated-orcid":false,"given":"Anas","family":"Mansour","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Al\u2010Azhar University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3080-2875","authenticated-orcid":false,"given":"Mohamed S.","family":"Elgendy","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Tanta University  Tanta Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1172-7574","authenticated-orcid":false,"given":"Omar","family":"Elkoumi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Suez University  Suez Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2807-3725","authenticated-orcid":false,"given":"Husam Abu","family":"Suilik","sequence":"additional","affiliation":[{"name":"Faculty of Medicine The Hashemite University  Zarqa Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suhaib El","family":"Khatib","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine UCHealth Parkview Medical Center  Pueblo Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1733-6891","authenticated-orcid":false,"given":"Naser","family":"Albekaen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Prince Hamza Hospital  Amman Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Moustafa","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rania","family":"Samir","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine Ain Shams University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Islam","family":"Saboukh","sequence":"additional","affiliation":[{"name":"Cardiology Department, Faculty of Medicine Kafr Elsheikh University  Kafr El Sheikh Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadica","family":"Trajkovska","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart and Diabetes Center NRW, Ruhr University Bochum  Bad Oeynhausen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angeliki","family":"Darma","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart and Diabetes Center NRW, Ruhr University Bochum  Bad Oeynhausen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Sciacca","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart and Diabetes Center NRW, Ruhr University Bochum  Bad Oeynhausen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Fink","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart and Diabetes Center NRW, Ruhr University Bochum  Bad Oeynhausen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2454-1335","authenticated-orcid":false,"given":"Moneeb","family":"Khalaph","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart and Diabetes Center NRW, Ruhr University Bochum  Bad Oeynhausen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0490-5862","authenticated-orcid":false,"given":"Christian","family":"Sohns","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart and Diabetes Center NRW, Ruhr University Bochum  Bad Oeynhausen 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