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Wolff-Parkinson-White
Preexcitation Patterns
Chapter 12
Artrioventricular Bypass Tract
•Accessory pathways form and fail to disappear during fetal development
•Formed near the mitral or tricuspid valves or interventricular septum
•An AV bypass tract is sometimes referred to as the bundle of Kent
Artrioventricular Bypass Tract
•From SA node directly to AV node AND ventricular myocardium
•Partially bypassing the bundle of His and purkinje fibers
Figure 12-5
Wolff-White-Parkinson
•Wide QRS
•not due to a delay in depolarization
•due to an early depolarization
•Shortened PR interval
•Upstroke QRS complex is slurred; delta wave
Wolff-Parkinson-White
•Short PR interval
•Wide QRS
•Delta Waves
Wolff-Parkinson-White
Wolff-Parkinson-White
•Fig 12-3 and 12-4
Wolff-Parkinson-White
•Bypass tracts can be located:
•left lateral
•posterior
•right
•anteroseptal (anterior)
F.Y.I.
Wolff-Parkinson-White
•As a general rule: the initial QRS complex (delta wave) vector will point away from the area of the ventricles that is first to be stimulated by the bypass tract
F.Y.I.
Wolff-Parkinson-White
• left lateral
• negative delta waves in I and/or aVL and positive in V1
• posterior
• positive delta waves in most of the precordial (chest) leads and negative in the inferior leads
• right
• negative delta waves in V1 and V2 and positive in I and V6
• anteroseptal (anterior)
• negative delta waves in leads V1 and V2
F.Y.I.
Clinical Significance
•Prone to arrhythmias
•paroxysmal supraventricular tachycardia (PSVT)
•Figure 12-5
•Mistaken for RBBB or MI
LaMarcus Aldridge Update
Forward LaMarcus Aldridge underwent a series of tests today at Providence St. Vincent’s Medical Center in Portland. He was diagnosed with Wolff-Parkinson-White Syndrome (WPW) and was treated for the condition by Dr. Daniel Oseran at St. Vincent’s. The procedure was successful.
Aldridge will be monitored by a cardiologist and will miss the remainder of the season. He is expected to make a full recovery and be cleared to resume physical activity, including basketball, in the near future.
Aldridge, complaining of dizziness, left Portland’s game against the Los Angeles Clippers at the Rose Garden on March 31 and has been sidelined since that time.
Accessory Pathways
