{
  "abstract": "Background: In Wolff–Parkinson–White (WPW) syndrome, accurate localization of accessory pathways before catheter ablation can improve procedural planning and efficiency. Several 12‐lead electrocardiographic (ECG) algorithms have been proposed, but their diagnostic performance has not been consistently established. We performed a systematic review and meta‐analysis to assess the accuracy of ECG‐based algorithms for accessory pathway localization in manifest WPW.\n\nMethods: Following PRISMA‐DTA recommendations, PubMed, EMBASE, Cochrane CENTRAL, Web of Science, and Scopus were searched from January 1990 to January 2026. Studies enrolling adult or pediatric patients with manifest pre‐excitation who underwent electrophysiological study (EPS) and catheter ablation were included. Successful localization during EPS/ablation served as the reference standard. Random‐effects models were used to calculate pooled diagnostic accuracy, sensitivity, specificity, and diagnostic odds ratios (DOR). Summary receiver operating characteristic and leave‐one‐out sensitivity analyses were also performed.\n\nResults: Seventeen studies involving 3159 patients met inclusion criteria. The pooled diagnostic accuracy of ECG algorithms was 0.91 (95% CI 0.85–0.94), although heterogeneity was substantial (I2 = 91.4%). Pooled sensitivity was 0.87 (95% CI 0.73–0.94), and pooled specificity was 0.98 (95% CI 0.95–0.99; I2 = 0%). The pooled DOR was 297.17 (95% CI 46.33–1906.19; p<0.0001). Sensitivity analyses showed stable results after sequential exclusion of individual studies.\n\nConclusion: Twelve‐lead ECG algorithms provide high diagnostic performance for accessory pathway localization in manifest WPW and may be useful adjuncts for pre‐ablation planning, although invasive electrophysiological mapping remains essential.",
  "abstract_shown": true,
  "affiliations": [
    "Faculty of Medicine Cairo University Cairo Egypt",
    "Faculty of Medicine Menoufia University Menoufia Egypt",
    "Department of Internal Medicine United Health Services—Wilson Medical Center Johnson City New York USA",
    "Faculty of Medicine Al‐Azhar University Cairo Egypt",
    "Faculty of Medicine Tanta University Tanta Egypt",
    "Faculty of Medicine Suez University Suez Egypt",
    "Faculty of Medicine The Hashemite University Zarqa Jordan",
    "Department of Internal Medicine UCHealth Parkview Medical Center Pueblo Colorado USA",
    "Department of Internal Medicine Prince Hamza Hospital Amman Jordan",
    "Department of Cardiology, Faculty of Medicine Ain Shams University Cairo Egypt",
    "Cardiology Department, Faculty of Medicine Kafr Elsheikh University Kafr El Sheikh Egypt",
    "Department of Electrophysiology, Heart and Diabetes Center NRW, Ruhr University Bochum Bad Oeynhausen Germany"
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 20,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Elsayed S. Moubarak",
      "orcid": "0009-0001-6178-8183"
    },
    {
      "affs": [
        1
      ],
      "name": "Ahmed Farid Gadelmawla",
      "orcid": "0000-0002-5802-2291"
    },
    {
      "affs": [
        2
      ],
      "name": "Almothana Manasrah",
      "orcid": "0009-0001-6266-4991"
    },
    {
      "affs": [
        3
      ],
      "name": "Anas Mansour",
      "orcid": "0009-0004-9111-320X"
    },
    {
      "affs": [
        4
      ],
      "name": "Mohamed S. Elgendy",
      "orcid": "0000-0003-3080-2875"
    },
    {
      "affs": [
        5
      ],
      "name": "Omar Elkoumi",
      "orcid": "0000-0003-1172-7574"
    },
    {
      "affs": [
        6
      ],
      "name": "Husam Abu Suilik",
      "orcid": "0000-0002-2807-3725"
    },
    {
      "affs": [
        7
      ],
      "name": "Suhaib El Khatib"
    },
    {
      "affs": [
        8
      ],
      "name": "Naser Albekaen",
      "orcid": "0009-0005-1733-6891"
    },
    {
      "affs": [
        0
      ],
      "name": "Ahmed Moustafa"
    },
    {
      "affs": [
        9
      ],
      "name": "Rania Samir"
    },
    {
      "affs": [
        10
      ],
      "name": "Islam Saboukh"
    },
    {
      "affs": [
        11
      ],
      "name": "Nadica Trajkovska"
    },
    {
      "affs": [
        11
      ],
      "name": "Angeliki Darma"
    },
    {
      "affs": [
        11
      ],
      "name": "Vanessa Sciacca"
    },
    {
      "affs": [
        11
      ],
      "name": "Thomas Fink"
    },
    {
      "affs": [
        11
      ],
      "name": "Moneeb Khalaph",
      "orcid": "0009-0004-2454-1335"
    },
    {
      "affs": [
        11
      ],
      "name": "Christian Sohns",
      "orcid": "0000-0003-0490-5862"
    },
    {
      "affs": [
        11
      ],
      "name": "Philipp Sommer"
    },
    {
      "affs": [
        10,
        11
      ],
      "name": "Hassan El‐Shirbiny",
      "orcid": "0000-0003-0411-4833"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5ae8f7z9c8xsz.bib",
  "cited_by": 0,
  "doi": "10.1111/pace.70387",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13739752/",
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    "0147-8389",
    "1540-8159"
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  "landing_url": "https://doi.org/10.1111/pace.70387",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Review"
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      "openalex",
      "2705|Cardiac Arrhythmias and Treatments"
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  "pdf_url": "https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/pace.70387",
  "pmcid": "PMC13739752",
  "pmid": "42578332",
  "published": "2026-08-11",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/5ae8f7z9c8xsz.ris",
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  ],
  "title": "Diagnostic Accuracy of 12‐Lead ECG Algorithms for Accessory Pathway Localization in WPW: A Meta‐Analysis",
  "title_text": "Diagnostic Accuracy of 12‐Lead ECG Algorithms for Accessory Pathway Localization in WPW: A Meta‐Analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-11-10T12:21:09Z",
  "url": "https://research.draconitic.com/paper/5ae8f7z9c8xsz",
  "venue": "Pacing and Clinical Electrophysiology",
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}