Accurate localization of accessory pathways in Wolff-Parkinson-White syndrome requires invasive electrophysiological assessment, primarily endocardial atrial mapping.
What are the most effective techniques for localizing accessory pathways in Wolff-Parkinson-White syndrome?
Invasive electrophysiological assessment, specifically endocardial atrial mapping, remains the gold standard for accurate localization of accessory pathways in WPW syndrome, though 12-lead ECG provides a reasonable first approximation.
Operative and ablative therapy in the Wolff-Parkinson-White syndrome requires accurate localization of accessory atrioventricular pathways. A reasonable first approximation to pathway location can be obtained by noninvasive techniques, the 12-lead electrocardiogram being the most readily available of these. Accurate characterization of the number and anatomic localization of accessory pathways still requires invasive electrophysiological assessment. The most useful technique for accessory pathway localization remains endocardial atrial mapping of the tricuspid and mitral (via the coronary sinus) ring during atrioventricular reciprocating tachycardia and ventricular pacing. Other techniques provide important confirmatory evidence and may be the only guides to accessory pathway location in selected individuals.
Szabó et al. (Sun,) conducted a review in Wolff-Parkinson-White syndrome. Localization techniques (12-lead ECG and endocardial atrial mapping) was evaluated. Accurate localization of accessory pathways in Wolff-Parkinson-White syndrome requires invasive electrophysiological assessment, primarily endocardial atrial mapping.
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