ECG EXAMPLE #4
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ECG #4 (12-lead ECG)
The patient was a 52 year old male referred because of palpitations. His ECG shows the typical features of preexcitation (Wolff-Parkinson-White ECG abnormality) with a short PR interval, wide QRS complexes caused by an initial delta wave (representing conduction to the ventricles via an accessory pathway) and secondary ST/T changes. The ECG abnormality may not be present all the time and typically when a patient with Wolff-Parkinson-White syndrome has an AV reciprocating tachycardia anterograde conduction occurs via the AV node and retrograde conduction to the atria via the accessory pathway thereby resulting in a normal QRS complex; this is known as orthodromic conduction. Occasionally the re-entrant loop occurs in the opposite (antidromic) direction, ie to the ventricles via the accessory pathway and retrogradely to the atria via the AV node.
The patient was a 52 year old male referred because of palpitations. His ECG shows the typical features of preexcitation (Wolff-Parkinson-White ECG abnormality) with a short PR interval, wide QRS complexes caused by an initial delta wave (representing conduction to the ventricles via an accessory pathway) and secondary ST/T changes. The ECG abnormality may not be present all the time and typically when a patient with Wolff-Parkinson-White syndrome has an AV reciprocating tachycardia anterograde conduction occurs via the AV node and retrograde conduction to the atria via the accessory pathway thereby resulting in a normal QRS complex; this is known as orthodromic conduction. Occasionally the re-entrant loop occurs in the opposite (antidromic) direction, ie to the ventricles via the accessory pathway and retrogradely to the atria via the AV node.