Document Detail

New observation of electrocardiogram during sinus rhythm on the atriofascicular and decremental atrioventricular pathways/clinical perspective: [corrected] terminal QRS [corrected] complex slurring or notching.
MedLine Citation:
PMID:  21985794     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Atriofascicular and decremental atrioventricular pathways are variants of accessory pathways with anterograde decremental conduction properties. They result in typical wide Quantronic Resonance System (QRS) tachycardia of left bundle branch block morphology. Data on the sinus rhythm electrocardiographic characteristics are limited.
METHODS AND RESULTS: Thirty patients with accessory pathways of anterograde decremental conduction properties were studied retrospectively (10 atriofascicular pathways and 20 decremental atrioventricular pathways). All patients had a pre-excited atrioventricular tachycardia with anterograde conduction over anterograde decrementally conducting fiber. Eighteen patients fulfilled criteria of minimal pre-excitation during sinus rhythm before ablation. In 10 patients (33%), delta wave was absent, and the only abnormality was terminal QRS slurring or notching on the ECG. It was mainly in leads I, V5, and V6. After ablation, terminal QRS slurring or notching disappeared in all 10 patients. We also did a survey in a control group comprised of 200 subjects without structural heart disease who were matched for age and sex. Terminal QRS slurring or notching was found in 3%.
CONCLUSIONS: This study showed a high prevalence of terminal QRS slurring or notching in patients with atriofascicular or decremental atrioventricular pathways. It can be the sole manifestation of such accessory pathways during sinus rhythm, and disappearance of terminal slurring or notching can be the only hallmark of successful ablation visible on the surface ECG.
Zili Liao; Jian Ma; Jiqiang Hu; Qian Yang; Shu Zhang
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Publication Detail:
Type:  Journal Article     Date:  2011-10-10
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  4     ISSN:  1941-3084     ISO Abbreviation:  Circ Arrhythm Electrophysiol     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-28     Completed Date:  2012-02-16     Revised Date:  2012-10-12    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  897-901     Citation Subset:  IM    
Center for Arrhythmia Diagnosis and Treatment, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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MeSH Terms
Accessory Atrioventricular Bundle / physiopathology*,  surgery
Adenosine / diagnostic use
Arrhythmias, Cardiac / diagnosis*,  physiopathology,  surgery
Cardiac Pacing, Artificial
Catheter Ablation
Electrophysiologic Techniques, Cardiac
Heart Conduction System / physiopathology*,  surgery
Middle Aged
Predictive Value of Tests
Retrospective Studies
Treatment Outcome
Young Adult
Reg. No./Substance:
Erratum In:
Circ Arrhythm Electrophysiol. 2012 Aug 1;5(4):e88

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

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