Wolff-Parkinson-White syndrome classification scheme: Difference between revisions
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{{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}} | {{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}} | ||
==EKG Classification== | ==Classification== | ||
===EKG Classification=== | |||
# Type A: | # Type A: | ||
#* Prominent [[R wave]] in lead V1 and V2. | #* Prominent [[R wave]] in lead V1 and V2. | ||
| Line 16: | Line 17: | ||
#* In both type A and B there may be abnormal q waves in leads 2, 3 and aVF. | #* In both type A and B there may be abnormal q waves in leads 2, 3 and aVF. | ||
==Variants of WPW== | ===Variants of WPW=== | ||
===[[Lown-Ganong-Levine Syndrome]] ([[LGL]])=== | ====[[Lown-Ganong-Levine Syndrome]] ([[LGL]])==== | ||
* There is a short [[PR interval]], but no delta wave | * There is a short [[PR interval]], but no delta wave | ||
* LGL is due to intranodal bypass tracts (i.e. there is conduction down the [[James fibers]]) | * LGL is due to intranodal bypass tracts (i.e. there is conduction down the [[James fibers]]) | ||
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* Normal [[P wave]] | * Normal [[P wave]] | ||
===[[Mahaim type preexcitation|Mahaim Type Preexcitation]]=== | ====[[Mahaim type preexcitation|Mahaim Type Preexcitation]]==== | ||
* This form of pre-excitation is due to nodoventricular, nodofascicular or fasciculoventricular connections | * This form of pre-excitation is due to 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 | ||
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[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category:Disease]] | |||
[[Category:Needs overview]] | |||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Revision as of 19:06, 12 January 2013
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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]
Classification
EKG Classification
- 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.
- 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)
- There is a short PR interval, but no delta wave
- LGL is due to intranodal bypass tracts (i.e. there is conduction down the James fibers)
- Normal QRS duration
- PR less than 0.12 seconds
- Normal P wave
Mahaim Type Preexcitation
- This form of pre-excitation is due to 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