Abstract

Identification of the site of successful radiofrequency catheter ablation (RFCA) for Wolff-Parkinson-White (WPW) syndrome may be subjective.The purpose of this study was to develop an automated signal analysis program to predict a successful ablation site.Patients who underwent successful RFCA for WPW from 2008- 2010 at our center were analyzed. Inclusion criteria were age <21 years, loss of preexcitation in <5 seconds, and sustained success at 3 months. Exclusion criteria were congenital heart disease and pacing during RFCA. The standard recording system signal was filtered into low frequency (LF 0-=0.02 Hz) and high frequency (HF >0.02-=0.45 Hz). Software identified the beginning of the HF signal, LF and R-wave peaks, LF/HF signal amplitude, and area under the HF/LF signals. Successful and unsuccessful (radiofrequency energy applied without accessory pathway block) signals were compared.Thirty patients were analyzed; 16 had both successful and unsuccessful signals, and 14 had a successful ablation with 1 radiofrequency application. Mean age was 13.7 ± 3.1 years, weight 54.9 ± 22.4 kg, and time to accessory pathway ablation 1.7 ± 1.4 seconds. Significant differences were found between successful and unsuccessful signals in area under HF signal, LF amplitude, LF to R time, HF ratio, and HF area × HF ratio. A receiver operating curve of HF area × HF ratio produced an area under the curve of 0.89. An HF area × HF ratio of 3.1 distinguished successful from unsuccessful signals with 100% specificity and 81% sensitivity.Automated signal analysis retrospectively differentiated successful from unsuccessful signals in patients undergoing RFCA for WPW. This software may improve the safety and efficacy of RFCA in children.

View details for DOI 10.1016/j.hrthm.2011.08.022

View details for Web of Science ID 000298640400002

View details for PubMedID 21872561