Document Detail


Electrocardiogram in patients with fasciculoventricular pathways: a comparative study with anteroseptal and midseptal accessory pathways.
MedLine Citation:
PMID:  15851255     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this study was to describe the ECG profile of a cohort of patients with fasciculoventricular pathways and compare the profile with the ECG of patients with anteroseptal and midseptal accessory pathways. BACKGROUND: Electrophysiologic findings suggest fasciculoventricular pathways insert into the septal region. Findings also suggest the 12-lead surface ECG during sinus rhythm is similar to the ECG of patients with anteroseptal and midseptal bypass tracts. METHODS: Four different observers analyzed the 12-lead ECG of seven patients with fasciculoventricular pathways (group I) and the ECG of 20 patients with midseptal AV accessory pathways (group II) and 20 patients with anteroseptal AV accessory pathways (group III). The following variables were analyzed: ECG frontal plane QRS and delta wave axis; angle between the QRS and the delta wave axis; QRS width; R/S ratio in lead III; presence of a negative delta wave in inferior leads; and precordial lead transition to R/S >1. RESULTS: The ECG of fasciculoventricular pathways shows a variable pattern. It shares some features with an anteroseptal accessory pathway and others with a midseptal accessory pathway. A narrower QRS width was the most important variable in distinguishing a fasciculoventricular pathway from a septally located AV bypass tract (P <.0001). The angle between the QRS and the delta wave frontal plane axis could differentiate a fasciculoventricular pathway from an anteroseptal bypass tract (P <.0001) but not from a midseptal accessory pathway. CONCLUSIONS: The sinus rhythm ECG of patients with fasciculoventricular pathways shows similarities with ECGs of patients with anteroseptal and midseptal accessory pathways, but the QRS complex usually is narrower. The ECG recorded during sinus rhythm cannot reliably differentiate fasciculoventricular pathways with a broad QRS complex from anteroseptal or midseptal bypass tracts.
Authors:
Eduardo Back Sternick; Luz-Maria Rodriguez; Luiz M Gerken; Hein J J Wellens
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  2     ISSN:  1547-5271     ISO Abbreviation:  Heart Rhythm     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-04-26     Completed Date:  2005-06-16     Revised Date:  2009-10-27    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1-6     Citation Subset:  IM    
Affiliation:
Department of Arrhythmia and Electrophysiology, Biocor Instituto, Nova Lima, Brazil. eduardosternick@aol.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Cohort Studies
Electrocardiography*
Electrophysiologic Techniques, Cardiac
Female
Heart Conduction System / physiopathology*
Humans
Male
Pre-Excitation Syndromes / diagnosis*,  physiopathology
Wolff-Parkinson-White Syndrome / physiopathology
Comments/Corrections
Comment In:
Heart Rhythm. 2005 Jan;2(1):7-9   [PMID:  15851256 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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