Perbandingan Akurasi Algoritma Easy-WPW, Algoritma Arruda dan Algoritma Pambrun dalam Menentukan Posisi Accesory Pathway pada Pasien dengan Wolff-Parkinson-White Syndrome di RSUP Haji Adam Malik Medan

Abstract

Introduction : Wolff-Parkinson-White Syndrome (WPW) is a form of ventricular pre-excitation in which part of the ventricular myocardium is depolarized early by one or more accessory pathways (AP) that pass through the atrioventricular (AV) node. In cases with severe or recurrent symptoms, electrophysiologic study EPS followed by catheter ablation using radiofrequency ablation (RFA) is recommended as definitive first-line therapy due to its high success rate. This study aimed to compare the accuracy of EASY-WPW algorithm with Arruda algorithm and Pambrun algorithm in determining the position of AP in patients with WPW at H. Adam Malik Hospital, Medan. Methods : This study is a cross sectional analytic study of patients with WPW syndrome who underwent EPS at HAM Hospital from January 2021 to August 2023. Then ECG data was read with three WPW algorithms by a cardiologist to see the concordance between AP location using ECG algorithm and AP location based on SEF. Intraobserver reliability analysis was also performed to minimize bias. Kappa coefficient >0.8 and P-value <0.05 indicated reliable measurement. Results : The number of subjects in this study were 27 people, consisting of 19 people (70.4%) male and eight people (29.6%) female with an average age of 35.5 ± 14.4 years. This study shows that the Easy WPW algorithm has the best accuracy with a suitability percentage of 74.1% followed by the Pambrun algorithm 70.4% and the Arruda algorithm has the lowest accuracy with a suitability percentage of 66.1%. From the results of the kappa test, the reading of the Easy WPW algorithm obtained a Kappa coefficient of 0.908 and a P-Value <0.01 so that the measurement results are reliable. Conclusion: Easy WPW algorithm is better than Arruda algorithm and Pambrun algorithm in determining AP position in WPW Syndrome patients at H Adam Malik Hospital Medan.