Despite numerous ECG algorithms being developed to localize the site of manifest accessory pathways (AP), they often require stepwise multiple‐lead analysis with variable accuracy, limitations, and reproducibility. The study aimed to develop a single‐lead ECG algorithm incorporating the P‐Delta interval (PDI) as an adjunct criterion to discriminate between right and left manifest AP.

Methods

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.

Results

A total of 140 WPW patients were included (70 for each group). A score‐based, single‐lead ECG algorithm was developed through derivation …