Wolff-Parkinson-White syndrome classification scheme: Difference between revisions
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==Variants of WPW== | ==Variants of WPW== | ||
===[[Lown-Ganong-Levine Syndrome]] ([[LGL]])=== | |||
#* | #* There is a short [[PR interval]], but no delta wave | ||
#* due to intranodal bypass tracts (i.e. there is conduction down James fibers) | #* 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 | #* [[PR]] less than 0.12 seconds | ||
#* | #* Normal [[P wave]] | ||
===Mahaim Type of 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 | ||
| Line 28: | Line 28: | ||
#* is rarer than WPW or LGL | #* is 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 18:54, 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
- 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 of 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
- is 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