Use of Right Electrocardiogram Chest Leads in Localization of Accessory Pathways in Patients with Wolff-Parkinson-White Syndrome

Abstract

olff-Parkinson-White (WPW) syndrome refers to the presence of a manifest accessory pathway (AP), thus resulting in the so-called pre-excitation, in combination with usually recurrent tachyarrhythmias. During sinus rhythm, a typical pattern in the resting ECG with the following characteristics is present: (i) a short PR interval (<120 ms); (ii) slurred upstroke (or downstroke) of the QRS complex (delta wave); and (iii) a wide QRS complex (>120 ms). In most cases, APs giving rise to the WPW pattern are seen in structurally normal hearts. Furthermore, various degrees of pre-excitation are possible depending on the location of the AP as well as on AVN conduction properties