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Updated: May 29, 2026

Electrophysiological Assessment of Murine Atria with High-Resolution Optical Mapping
Published on: February 22, 2018
Accuracy of algorithms to predict accessory pathway location in children with Wolff-Parkinson-White syndrome
Christopher Wren1, Melanie Vogel, Stephen Lord
1Freeman Hospital, Newcastle upon Tyne, UK. christopher.wren@nuth.nhs.uk
Objective:
The aim of this study was to examine the accuracy in predicting pathway location in children with Wolff-Parkinson-White syndrome for each of seven published algorithms.
Patients And Interventions:
ECGs from 100 consecutive children with Wolff-Parkinson-White syndrome undergoing electrophysiological study were analysed by six investigators using seven published algorithms, six of which had been developed in adult patients.
Main Outcome Measures:
Accuracy and concordance of predictions were adjusted for the number of pathway locations.
Results:
Accessory pathways were left-sided in 49, septal in 20 and right-sided in 31 children. Overall accuracy of prediction was 30-49% for the exact location and 61-68% including adjacent locations. Concordance between investigators varied between 41% and 86%. No algorithm was better at predicting septal pathways (accuracy 5-35%, improving to 40-78% including adjacent locations), but one was significantly worse. Predictive accuracy was 24-53% for the exact location of right-sided pathways (50-71% including adjacent locations) and 32-55% for the exact location of left-sided pathways (58-73% including adjacent locations).
Conclusions:
All algorithms were less accurate in our hands than in other authors' own assessment. None performed well in identifying midseptal or right anteroseptal accessory pathway locations.
