Wolff-Parkinson-White syndrome classification scheme: Difference between revisions

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* Normal [[P wave]]
* Normal [[P wave]]


===Mahaim Type of Preexcitation===
===Mahaim Type Preexcitation===
#* nodoventricular, nodofascicular or fasciculoventricular connections
* Nodoventricular, nodofascicular or fasciculoventricular connections
#* the impulse may travel through the AV node normally and this may then be followed by premature conduction to the basal ventricular myocardium
* The impulse may travel through the [[AV node]] normally and this may then be followed by premature conduction to the basal ventricular myocardium
#* there is a delta wave with a normal PR interval  
* There is a delta wave with a normal [[PR interval]]
#* is rarer than WPW or LGL
* Rarer than [[WPW]] or [[LGL]]
#* in older patients there can be a prolonged conduction down the accessory pathway resulting in a normal PR interval in the presence of WPW which is tough to distinguish from Mahaim fibers
* In older patients there can be a prolonged conduction down the accessory pathway resulting in a normal PR interval in the presence of WPW which is tough to distinguish from Mahaim fibers


==References==
==References==

Revision as of 18:57, 16 May 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

EKG Classification

  1. Type A:
    • Prominent R wave in lead V1 and V2.
    • It has been found at EP studies that these patients have early activation of the left ventricle.
    • Generally V1 shows either a notched R wave or RS or Rsr' deflection
    • Mimics a posterior MI, RVH
  2. Type B:
    • Prominent S wave deflection in the right precordial leads, and upright R waves in the lateral precordial leads.
    • EP studies have showed that this form of WPW syndromes is due to early activation of the lateral aspect of the right ventricle
    • This form is more common.
    • May resemble an abnormal Q wave in the right precordial leads and be mistaken for an anterior MI
    • In both type A and B there may be abnormal q waves in leads 2, 3 and aVF.


Variants of WPW

Lown-Ganong-Levine Syndrome (LGL)

Mahaim Type Preexcitation

  • Nodoventricular, nodofascicular or fasciculoventricular connections
  • The impulse may travel through the AV node normally and this may then be followed by premature conduction to the basal ventricular myocardium
  • There is a delta wave with a normal PR interval
  • Rarer than WPW or LGL
  • In older patients there can be a prolonged conduction down the accessory pathway resulting in a normal PR interval in the presence of WPW which is tough to distinguish from Mahaim fibers

References

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