594Ventricular dysfunction in wolff-parkinson-white syndrome- a worry only in septal pathways?
Bibliographic record
Abstract
Introduction: Ventricular preexcitation in Wolff-Parkinson-White (WPW) Syndrome is associated with ventricular dysfunction. Our aim was to determine the prevalence of ventricular dysfunction and to assess risk factors associated with this condition. Methods: A retrospective analysis of all patients < 18 years of age with WPW Syndrome and normal cardiac anatomy who underwent an electrophysiology study (EPS) at our institution between January 1988 to December 2014. Ventricular dysfunction was defined as EF < 55%. Patients with EF ≧ 55% were used as controls. Results: There were 13/314 (4.1%) cases with ventricular dysfunction (median EF 46%[17-55%]). The median age was 23 months (0-199). Heart failure was the presenting symptom in 4/13 (31%), and only 5/13 (38%) had tachyarrhythmias. QRS duration was comparable (125 ± 25 vs 120 ± 21 msec, p=0.223). Pathway location varied; 3 right postero-lateral, 3 right postero-septal, 3 right antero-septal, 3 right antero-lateral, 2 right anterior, and 1 left posterior. Right antero-lateral pathways were more common (3/13 [23.1%] vs 9/301 [3%], p=0.01) and was associated with increased risk of developing ventricular dysfunction (OR 9.73, CI 2.2-41.5). Multiple pathways (2/13[15%] vs 29/301[9.6%], p=0.374) or pathway characteristics were comparable; AP ERP 340 msec vs 333 msec (p=0.312), shortest preexcited cycle length with atrial pacing 321 msec vs 304 msec (p=0.36). Conclusion: Ventricular dysfunction in WPW Syndrome is rare but can develop in right-sided pathways. Right antero-lateral pathway location was associated with increased risk of ventricular dysfunction. In the absence of clear risk factors, close follow-up regardless of arrhythmia burden is indicated.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".